Zymfentra J Code: J1748

Self-Administered Drug Exclusion 6 Medicare Administrative Contractors list J1748 as usually self-administered and exclude it from Part B coverage in their jurisdictions. Check the article for your MAC before billing: First Coast, Noridian (A53032), Noridian (A53033), Novitas, Palmetto, Wellpoint Federal, WPS · All SAD lists →

Drug & Product Overview

HCPCS Descriptor Injection, infliximab-dyyb (zymfentra), 10 mg

HCPCS Added Date July 1, 2024

Manufacturer Celltrion USA

Route of Administration Subcutaneous

Generic Status Single-Source; Branded

Dosage Form Kit

About Zymfentra

Zymfentra is a medication aligned to the HCPCS J Code: J1748 for billing, pricing, and reimbursement purposes in the United States. Classified under Immunology: Anti-TNF, it is administered via the subcutaneous route and manufactured by Celltrion USA.

Manufacturers, reach out to us to add more information.

NDC Code Information

3 NDC packages are crosswalked to J1748. Package detail is available to logged-in subscribers.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
•••••-••••-•• Log in to view	Zymfentra
	Zymfentra
	Zymfentra

Login to view 3 NDC packages View pricing, complete NDC-to-HCPCS alignments, and package details.

Zymfentra Pricing & Reimbursement

J1748 Private Payer Reimbursement

$270.07 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Infliximab Biosimilar Information:

Zymfentra Approval Date: April 5, 2016

Product Name	HCPCS Code	Active Ingredient	BLA Type
Remicade	J1745	Infliximab	351(a) Originator Product
Inflectra	J1748	Infliximab	351(k) Biosimilar
Inflectra	Q5103	Infliximab	351(k) Biosimilar
Renflexis	Q5104	Infliximab	351(k) Biosimilar
Avsola	Q5121	Infliximab	351(k) Biosimilar

Zymfentra CPT Administration Codes

CPT Code	Description
96372	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular

Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

Zymfentra Medically Unlikely Edits (MUE)

The most billing units of J1748 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg.

Practitioner Office & Hospital Outpatient

12 units / day

= 120 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 →

Zymfentra 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 Ulcerative Colitis

Frequently Asked Questions

Is there an available Zymfentra billing and coding guide?

Billing and coding information for Zymfentra can be found through Celltrion Usa. Visit Here →

Are there any available Zymfentra patient assistance programs?

Zymfentra patient assistance information can be found through Celltrion Usa. Visit Here →

Where can I find Zymfentra prescribing information?

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

Where can I find Zymfentra side effect information?

Our team did not identify a source of side effect information for Zymfentra.

Does billing Zymfentra require JZ/JW wastage modifiers?

CMS does not include Zymfentra (J1748) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1748. For more information, visit the link below.

About BuyandBill.com:

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