Home › Drug Codes › J Codes › J1628 · TREMFYA
Updated July 1st, 2026

TREMFYA J Code: J1628

Injection, guselkumab, 1 mg

Login to unlock all benchmarks

Q4 2026 Medicare Payment Limit for J1628, effective October 1, 2026: $66.998 per HCPCS billing unit, up 0.1% from $66.92. From CMS's final file.

?
Medicare Payment Limit ?
$66.92
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$66.92
/ HCPCS billing unit · APC 9029
ASP ?
$•••.••
Login to view
WAC · AWP ?
$•••.••
Login to view
NDCs Crosswalked ?
10
View NDC crosswalk →
Self-Administered Drug Exclusion 7 Medicare Administrative Contractors list J1628 as usually self-administered and exclude it from Part B coverage in their jurisdictions. Check the article for your MAC before billing: CGS, First Coast, Noridian (A53032), Noridian (A53033), Novitas, Palmetto, Wellpoint Federal, WPS · All SAD lists →

Drug & Product Overview

HCPCS Descriptor Injection, guselkumab, 1 mg
HCPCS Added Date January 1, 2019
Manufacturer Janssen
Route of Administration Intravenous, Subcutaneous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection

About TREMFYA

Tremfya is a medication aligned to the HCPCS J Code: J1628 for billing, pricing, and reimbursement purposes in the United States. Classified under Immunology: Anti-TNF, it is administered via the intravenous or subcutaneous routes and manufactured by Janssen.

According to CMS Drug Use Information: This medication is used to treat plaque psoriasis and psoriatic arthritis. It is also used to treat certain bowel diseases (Crohn's disease, ulcerative colitis). Guselkumab belongs to a class of drugs known as monoclonal antibodies. It works by blocking a certain natural substance in your body (interleukin-23) that may cause inflammation and swelling.

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. Showing 5 of 10 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
57894-0640-01 Tremfya Janssen Biotech, Inc. 100 100 MG / 1 ML
57894-0640-06 Tremfya Janssen Biotech, Inc. 100 100 MG / 1 ML
57894-0640-11 Tremfya Janssen Biotech, Inc. 100 100 MG / 1 ML
57894-0650-02 Tremfya Janssen Biotech, Inc. 200 200 MG / 20 ML
57894-0651-02 Tremfya Janssen Biotech, Inc. 200 200 MG / 2 ML
•••••-••••-•• Log in to view TREMFYA
TREMFYA
TREMFYA
Login to view 5 more NDC packages View pricing, complete NDC-to-HCPCS alignments, and package details.
Login →

TREMFYA Pricing & Reimbursement

J1628 Private Payer Reimbursement
$74.06 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →
UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

TREMFYA 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)
96372 Login for More Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular Login for More
Not on the CMS JW / JZ list

CMS does not include Tremfya (J1628) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1628. Wastage billing guide →

TREMFYA Medically Unlikely Edits (MUE)

The most billing units of J1628 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient
200 units / day
= 200 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.

TREMFYA 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.

Crohn's Disease Plaque Psoriasis Psoriatic Arthritis Ulcerative Colitis
Drug Class
Interleukin-23 Antagonist [EPC]Interleukin-23 Antagonists [MoA]

Login for BuyandBill.com Analytics

Unlock deeper insights with BuyandBill’s Comparative Report!

  • Compare ASP, WAC, and AWP across drugs.
  • Visualize Drug Price Movement Over Time
  • Tailor reports to drug class, manufacturer, or HCPCS Code.
  • Compare Biosimilar and 505(b)(2) products.
Access Full Report →

Frequently Asked Questions

Is there an available Tremfya billing and coding guide?
Billing and coding information for TREMFYA can be found through Janssen. Visit Here →
Are there any available Tremfya patient assistance programs?
TREMFYA patient assistance information can be found through Janssen. Visit Here →
Where can I find Tremfya prescribing information?
TREMFYA prescribing information can be found at the link below: Visit Here →
Where can I find Tremfya side effect information?
Information regarding TREMFYA's side effects can be found at MedlinePlus Visit Here →
Does billing TREMFYA require JZ/JW wastage modifiers?
CMS does not include TREMFYA (J1628) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1628. For more information, visit the link below.

About BuyandBill.com:

The BuyandBill.com team is dedicated to delivering high-quality coding and billing information for office-administered drugs. We continuously research HCPCS-coded medications to expand our resources and ensure data accuracy. Manufacturers: click here to sponsor your medication, and we will ensure the most accurate and detailed information is displayed.

Related Drug Codes

Explore billing, coding, and pricing for drugs related to TREMFYA.

J0139HUMIRAInjection, adalimumab, 1 mgAbbvieAdded January 1, 2025J0717CIMZIAInjection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)UCB PharmaAdded January 1, 2014J1745RemicadeInjection, infliximab, excludes biosimilar, 10 mgJanssenAdded January 1, 2000J3357STELARAUstekinumab, for subcutaneous injection, 1 mgJanssenAdded January 1, 2011Q5103INFLECTRAInjection, infliximab-dyyb, biosimilar, (inflectra), 10 mgPfizerAdded April 1, 2018Q5104RENFLEXISInjection, infliximab-abda, biosimilar, (renflexis), 10 mgOrganonAdded April 1, 2018Q5121AvsolaInjection, infliximab-axxq, biosimilar, (avsola), 10 mgAmgenAdded July 1, 2020Q5140HULIOInjection, adalimumab-fkjp, biosimilar, 1 mgBiocon Biologics IncAdded January 1, 2025Q5141YUFLYMAInjection, adalimumab-aaty, biosimilar, 1 mgCelltrion USAAdded January 1, 2025Q5142SIMLANDIInjection, adalimumab-ryvk biosimilar, 1 mgTevaAdded January 1, 2025