{
    "code": "J0221",
    "coding_system": "HCPCS",
    "canonical_url": "https://localishealth.com/hcpcs/J0221/2014/B",
    "release_specific_url": "https://localishealth.com/hcpcs/J0221/2016/C",
    "description": "Lumizyme injection",
    "answer": {
        "question": "Did Medicare pay separately for HCPCS J0221 in Q3 2016?",
        "text": "Not at a published national rate. HCPCS J0221 carries status E (excluded) in the Q3 2016 release. A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. Treat the blank amount as unpriced, not as $0."
    },
    "release": {
        "schedule": "pfs",
        "year": 2016,
        "quarter": "C",
        "label": "Q3 2016",
        "effective": "July 1 – September 30, 2016",
        "revision": 1
    },
    "status": {
        "code": "E",
        "non_facility_payable": false,
        "facility_payable": false
    },
    "national_rates_usd": {
        "office_non_facility": null,
        "facility": null,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": null,
        "practice_expense_non_facility": null,
        "practice_expense_facility": null,
        "malpractice": null
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.8043,
    "source": {
        "label": "Physician relative value file (Q3 2016)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu16c.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2016/C",
        "file": "PPRRVU16_V0517.csv",
        "row": 2542,
        "sha256": "81464316ee60bdd4aa33b47a636b521a77a73481c795300cbab67f48dbe432d9"
    },
    "modified_at": "2026-08-04T03:06:56+00:00"
}