J9011 HCPCS code: Injection, datopotamab deruxtecan-dlnk, 1 mg
J9011 is the HCPCS Level II code for injection, datopotamab deruxtecan-dlnk, 1 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 600 per day on outpatient hospital claims.
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 | 2025-10-01 |
| Last action effective | 2025-10-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 600 | CMS Policy |
| practitioner claims | 600 | CMS Policy |
What changed for J9011
- October 2025: Code appears in this HCPCS release
- 2025-10-01: J9011 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 J9011?
J9011 is the HCPCS Level II code for injection, datopotamab deruxtecan-dlnk, 1 mg. Short descriptor: "Datopotamab deruxtecan, 1 mg".
Does Medicare cover J9011?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9011 can be billed per day?
600 on outpatient hospital claims; 600 on practitioner claims (NCCI medically unlikely edits).
Related J90 codes
- J9000 — Injection, doxorubicin hydrochloride, 10 mg
- J9003 — Leuprolide injectable (camcevi etm), 1 mg
- J9010 — Injection, alemtuzumab, 10 mg
- J9015 — Injection, aldesleukin, per single use vial
- J9017 — Injection, arsenic trioxide, 1 mg
- J9019 — Injection, asparaginase (erwinaze), 1,000 iu
- J9020 — Injection, asparaginase, not otherwise specified, 10,000 units
- J9021 — Injection, asparaginase, recombinant, (rylaze), 0.1 mg
- J9022 — Injection, atezolizumab, 10 mg
- J9023 — Injection, avelumab, 10 mg
- J9024 — Injection, atezolizumab, 5 mg and hyaluronidase-tqjs
- J9025 — Injection, azacitidine, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J9011
- Watch J9011 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9011
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.