SYFOVRE J Code: J2781

Drug & Product Overview

HCPCS Descriptor Injection, pegcetacoplan, intravitreal, 1 mg

HCPCS Added Date October 1, 2023

Manufacturer Apellis Pharmaceuticals

Route of Administration Intravitreal

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Solution

About SYFOVRE

Syfovre is a medication aligned to the HCPCS J Code: J2781 for billing, pricing, and reimbursement purposes in the United States. This Ophthalmology medication is administered via the intravitreal route and manufactured by Apellis Pharmaceuticals.

According to CMS Drug Use Information: Pegcetacoplan is used to treat a certain serious eye condition (geographic atrophy). It may help to delay vision loss. Pegcetacoplan works by helping to block your immune system from destroying cells in your eye.

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
73606-0020-01	Syfovre	Apellis Pharmaceuticals, Inc.	15	15 MG / 0.1 ML
73606-0020-02	Syfovre	Apellis Pharmaceuticals, Inc.	15	15 MG / 0.1 ML

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SYFOVRE Pricing & Reimbursement

J2781 Private Payer Reimbursement

$140.32 / 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 Q4 2026

SYFOVRE CPT Administration Codes

CPT Code	Description
67028	Intravitreal injection of a pharmacologic agent (separate procedure) 67028

JW / JZ modifiers apply

CMS has identified Syfovre (J2781) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

SYFOVRE Medically Unlikely Edits (MUE)

The most billing units of J2781 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

30 units / day

= 30 mg per day

MAI 2 · Date of Service Edit: Policy. Absolute per-day limit set by policy or regulation; units above it are not payable, and denials are not appealable on medical-necessity grounds. See all MUE limits →

SYFOVRE 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.

Geographic atrophy secondary to age-related macular degeneration

Drug Class

Complement Inhibitor [EPC]Complement Inhibitors [MoA]

Frequently Asked Questions

Is there an available Syfovre billing and coding guide?

Billing and coding information for SYFOVRE can be found through APELLIS PHARMACEUTICALS. Visit Here →

Are there any available Syfovre patient assistance programs?

SYFOVRE patient assistance information can be found through APELLIS PHARMACEUTICALS. Visit Here →

Where can I find Syfovre prescribing information?

SYFOVRE prescribing information can be found at the link below: Visit Here →

Where can I find Syfovre side effect information?

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

Does billing SYFOVRE require JZ/JW wastage modifiers?

CMS has identified SYFOVRE(J2781) 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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