Last Updated: April 1st, 2024



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.


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