J1323 HCPCS code: Injection, elranatamab-bcmm, 1 mg
J1323 is the HCPCS Level II code for injection, elranatamab-bcmm, 1 mg. In 2024 Medicare paid an average of $141.08 per service for J1323 across 42,768 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 76 per day on outpatient hospital claims. In 2024, about 121 clinicians billed Medicare for J1323 for 65 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1D — Chemotherapy |
| Added | 2024-04-01 |
| Last action effective | 2024-04-01 |
Who bills J1323 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 121 |
| Medicare beneficiaries | 65 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1323, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 42,768 | 65 | $177.08 | $141.08 |
States with the most J1323 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Tennessee | 9,496 | $141.16 |
| Washington | 8,468 | $141.19 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 76 | Prescribing Information |
| practitioner claims | 76 | Prescribing Information |
What changed for J1323
- 2024-04-01: J1323 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J1323?
J1323 is the HCPCS Level II code for injection, elranatamab-bcmm, 1 mg. Short descriptor: "Inj, elranatamab-bcmm, 1 mg".
How much does Medicare pay for J1323?
In 2024, the average Medicare payment was $141.08 per service (average allowed $177.08).
Does Medicare cover J1323?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1323 can be billed per day?
76 on outpatient hospital claims; 76 on practitioner claims (NCCI medically unlikely edits).
Related J13 codes
- J1300 — Injection, eculizumab, 10 mg
- J1301 — Injection, edaravone, 1 mg
- J1302 — Injection, sutimlimab-jome, 10 mg
- J1303 — Injection, ravulizumab-cwvz, 10 mg
- J1304 — Injection, tofersen, 1 mg
- J1305 — Injection, evinacumab-dgnb, 5mg
- J1306 — Injection, inclisiran, 1 mg
- J1307 — Injection, crovalimab-akkz, 10 mg
- J1308 — Injection, famotidine, 0.25 mg
- J1320 — Injection, amitriptyline hcl, up to 20 mg
- J1322 — Injection, elosulfase alfa, 1 mg
- J1324 — Injection, enfuvirtide, 1 mg
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J1323
- Watch J1323 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1323
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.