Home › Drug Codes › J Codes › J2507 · KRYSTEXXA
Updated July 1st, 2026

KRYSTEXXA J Code: J2507

Injection, pegloticase, 1 mg

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Q4 2026 Medicare Payment Limit for J2507, effective October 1, 2026: $4,000.629 per HCPCS billing unit, up 1.8% from $3,929.337. From CMS's final file.

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Medicare Payment Limit ?
$3,929.337
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$3,929.337
/ HCPCS billing unit · APC 9281
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
2
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Drug & Product Overview

HCPCS Descriptor Injection, pegloticase, 1 mg
HCPCS Added Date January 1, 2012
Manufacturer Amgen
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Solution

About KRYSTEXXA

Krystexxa is a medication aligned to the HCPCS J Code: J2507 for billing, pricing, and reimbursement purposes in the United States. Classified under Immunology, it is administered via the intravenous route and manufactured by Amgen.

According to CMS Drug Use Information: Pegloticase is used to treat gout which has not responded to the usual treatments. It works by lowering high levels of uric acid in your body. Increased uric acid in your body can cause gout.

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
75987-0058-01 Krystexxa Horizon Therapeutics USA, Inc. 8 8 MG / 50 ML
75987-0080-10 Krystexxa Horizon Therapeutics USA, Inc. 8 8 MG / 1 ML
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KRYSTEXXA Pricing & Reimbursement

J2507 Private Payer Reimbursement
$3,768.61 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

KRYSTEXXA CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
JW / JZ modifiers apply

CMS has identified Krystexxa (J2507) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

KRYSTEXXA Medically Unlikely Edits (MUE)

The most billing units of J2507 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient
8 units / day
= 8 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 →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

KRYSTEXXA 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.

chronic gout refractory to conventional therapy
Drug Class
Urate Oxidase [CS]Uric Acid-specific Enzyme [EPC]

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Frequently Asked Questions

Is there an available Krystexxa billing and coding guide?
Billing and coding information for KRYSTEXXA can be found through Horizon Therapeutics. Visit Here →
Are there any available Krystexxa patient assistance programs?
KRYSTEXXA patient assistance information can be found through Horizon Therapeutics. Visit Here →
Where can I find Krystexxa prescribing information?
KRYSTEXXA prescribing information can be found at the link below: Visit Here →
Where can I find Krystexxa side effect information?
Information regarding KRYSTEXXA's side effects can be found at MedlinePlus Visit Here →
Does billing KRYSTEXXA require JZ/JW wastage modifiers?
CMS has identified KRYSTEXXA(J2507) 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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