VIMIZIM J Code: J1322

Drug & Product Overview

HCPCS Descriptor Injection, elosulfase alfa, 1 mg

HCPCS Added Date January 1, 2015

Manufacturer Biomarin Pharmaceuticals

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Solution, Concentrate

About VIMIZIM

Vimizim is a medication aligned to the HCPCS J Code: J1322 for billing, pricing, and reimbursement purposes in the United States. Classified under Enzyme Replacement Therapy, it is administered via the intravenous route and manufactured by Biomarin Pharmaceuticals.

According to CMS Drug Use Information: Elosulfase alfa is used to treat a certain inherited condition (mucopolysaccharidosis type IVA-Morquio A syndrome) that causes a buildup of certain substances (glycosaminoglycans-GAGs) in the body. Elosulfase alfa works by breaking down GAGs in the body.

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
68135-0100-01	Vimizim	BioMarin Pharmaceutical Inc.	5	5 MG / 5 ML

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VIMIZIM Pricing & Reimbursement

J1322 Private Payer Reimbursement

$311.71 / 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 Q3 2026

VIMIZIM CPT Administration Codes

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 Vimizim (J1322) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

VIMIZIM Medically Unlikely Edits (MUE)

The most billing units of J1322 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

150 units / day

= 150 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 →

VIMIZIM 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.

Mucopolysaccharidosis type IVA (MPS IVA; Morquio A syndrome)

Drug Class

Hydrolytic Lysosomal Glycosaminoglycan-specific Enzyme [EPC]alpha-Glucosidases [CS]

Frequently Asked Questions

Is there an available Vimizim billing and coding guide?

Our team has not identified a manufacturer-published source of billing and coding information for VIMIZIM.

Are there any available Vimizim patient assistance programs?

VIMIZIM patient assistance information can be found through Biomarin Pharma. Visit Here →

Where can I find Vimizim prescribing information?

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

Where can I find Vimizim side effect information?

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

Does billing VIMIZIM require JZ/JW wastage modifiers?

CMS has identified VIMIZIM(J1322) 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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