Khapzory J Code: J0642

Drug & Product Overview

HCPCS Descriptor Injection, levoleucovorin (khapzory), 0.5 mg

HCPCS Added Date October 1, 2019

Manufacturer Acrotech Biopharma

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Powder, Lyophilized, For Solution

About Khapzory

Khapzory is a medication aligned to the HCPCS J Code: J0642 for billing, pricing, and reimbursement purposes in the United States. This Oncology medication is administered via the intravenous route and manufactured by Acrotech Biopharma.

According to CMS Drug Use Information: This medication is used to treat or prevent serious blood cell disorders (such as thrombocytopenia, neutropenia, anemia) caused by certain drugs (folic acid antagonists such as methotrexate, trimethoprim, pyrimethamine). Some brands may also be used with a certain cancer drug (5-fluorouracil) to treat patients with colon cancer.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
72893-0004-01	Khapzory	Acrotech Biopharma Inc	350	175 MG / 3.5 ML

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Khapzory Pricing & Reimbursement

J0642 Private Payer Reimbursement

$1.35 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

Levoleucovorin 505(b)(2) Information:

HCPCS Code	Manufacturer	Active Ingredient	HCPCS Description
J0642	Acrotech Biopharma	Levoleucovorin	Injection, levoleucovorin (khapzory), 0.5 mg

Khapzory CPT Administration Codes

CPT Code	Description
96413	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415	Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)

JW / JZ modifiers apply

CMS has identified Khapzory (J0642) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

Khapzory Medically Unlikely Edits (MUE)

The most billing units of J0642 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.5 mg.

Practitioner Office & Hospital Outpatient

1,200 units / day

= 600 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

Khapzory Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Folic acid antagonist overdosage or impaired methotrexate elimination Metastatic colorectal cancer Osteosarcoma

Drug Class

Folate Analog [EPC]Folic Acid [CS]

Frequently Asked Questions

Is there an available Khapzory billing and coding guide?

Our team has not identified a manufacturer-published source of billing and coding information for Khapzory.

Are there any available Khapzory patient assistance programs?

Khapzory patient assistance information can be found through Acrotech Biopharma. Visit Here →

Where can I find Khapzory prescribing information?

Khapzory prescribing information can be found at the link below. Please reach out to us if you believe this information to be innacurate or out of date. Visit Here →

Where can I find Khapzory side effect information?

Our team has not yet identified a source of side effects information for Khapzory. Please check back in a few weeks.

Does billing Khapzory require JZ/JW wastage modifiers?

CMS has identified Khapzory(J0642) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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