Genzyme

LUMIZYME - Cost

Last Updated: April 1st, 2024

HCPCS:

J0221

HCPCS Code Descriptor:

Injection, alglucosidase alfa, (lumizyme), 10 mg

Medicare Payment Limit:

The LUMIZYME Medicare Payment Limit is $197.303

Average Sale Price:

LUMIZYME ASP cost available once logged in.

Medicare Co-Insurance Percentage:

The LUMIZYME Medicare Co-insurance percentage is 20%. LUMIZYME's Medicare Co-insurance amount is $39.46 per HCPCS unit.

APC Code:

The Lumizyme APC Code is: 1413

APC Payment Limit:

The APC Payment Limit for LUMIZYME is available. Login to view.

Lumizyme Cost Information:

Lumizyme, a medication with HCPCS code J0221, was added and became effective January 1, 2012. Lumiyme's AWP remained at a consistent level between January 2016 and December 2017, before increasing slightly and remaining consistent for a few months. Between January 2016 and March 2023, Lumizyme's AWP saw sporadic increases, amounting to about a 20% price increase. In April 2023, there was a steep drop in the AWP but it returned to it's normal level in July 2023. The WAC has followed a similar trend, with intermittent price increases between January 2016 and March 2023, then a steep decline in April 2023 before returning to normal levels in July 2023. The drops in the WAC and the AWP in April 2023 both coincide with a new NDC entering the market. The ASP has remained fairly close in price to the WAC, but has not seen any sharp decreases.

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Lumizyme’s wholesale acquisition cost (WAC) information was last updated on:
January 5, 2024
Lumizyme’s average wholesale price (AWP) information was last updated on:
January 5, 2024