J9023 HCPCS code: Injection, avelumab, 10 mg
J9023 is the HCPCS Level II code for injection, avelumab, 10 mg. In 2024 Medicare paid an average of $72.65 per service for J9023 across 426,492 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 140 per day on outpatient hospital claims. Medicare volume fell 19% from 2022 to 2024 (529,300 to 426,492 services). In 2024, about 908 clinicians billed Medicare for J9023 for 436 beneficiaries; Florida, Texas, California accounted for 41% of services.
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 | O1E — Other drugs |
| Added | 2018-01-01 |
| Last action effective | 2018-01-01 |
Who bills J9023 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 908 |
| Medicare beneficiaries | 436 |
| States with claims | 17 |
| Share of services in top 3 states (Florida, Texas, California) | 41% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9023, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 529,300 | 667 | $85.83 | $68.52 |
| 2023 | 540,489 | 618 | $87.66 | $69.83 |
| 2024 | 426,492 | 436 | $91.23 | $72.65 |
States with the most J9023 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 66,895 | $73.08 |
| Texas | 35,280 | $69.78 |
| California | 28,448 | $71.42 |
| Illinois | 22,980 | $71.92 |
| Arizona | 19,932 | $73.23 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 140 | Clinical: Data |
| practitioner claims | 140 | Clinical: Data |
What changed for J9023
- 2018-01-01: J9023 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 J9023?
J9023 is the HCPCS Level II code for injection, avelumab, 10 mg. Short descriptor: "Injection, avelumab, 10 mg".
How much does Medicare pay for J9023?
In 2024, the average Medicare payment was $72.65 per service (average allowed $91.23).
Does Medicare cover J9023?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9023 can be billed per day?
140 on outpatient hospital claims; 140 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
- J9011 — Injection, datopotamab deruxtecan-dlnk, 1 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
- 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 J9023
- Watch J9023 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9023
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.