J9057 HCPCS code: Injection, copanlisib, 1 mg
J9057 is the HCPCS Level II code for injection, copanlisib, 1 mg. In 2023 Medicare paid an average of $56.31 per service for J9057 across 18,371 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 60 per day on outpatient hospital claims. Medicare volume rose 8% from 2022 to 2023 (17,008 to 18,371 services). In 2023, about 44 clinicians billed Medicare for J9057 for 25 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 | 2019-01-01 |
| Last action effective | 2019-01-01 |
Who bills J9057 (2023)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 44 |
| Medicare beneficiaries | 25 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9057, 2022–2023
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 17,008 | 26 | $85.26 | $68.03 |
| 2023 | 18,371 | 25 | $70.69 | $56.31 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 60 | Prescribing Information |
| practitioner claims | 60 | Prescribing Information |
What changed for J9057
- 2019-01-01: J9057 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 J9057?
J9057 is the HCPCS Level II code for injection, copanlisib, 1 mg. Short descriptor: "Inj., copanlisib, 1 mg".
How much does Medicare pay for J9057?
In 2023, the average Medicare payment was $56.31 per service (average allowed $70.69).
Does Medicare cover J9057?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9057 can be billed per day?
60 on outpatient hospital claims; 60 on practitioner claims (NCCI medically unlikely edits).
Related J90 codes
- J9000 — Injection, doxorubicin hydrochloride, 10 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
- J9023 — Injection, avelumab, 10 mg
- J9024 — Injection, atezolizumab, 5 mg and hyaluronidase-tqjs
- J9025 — Injection, azacitidine, 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 J9057
- Watch J9057 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9057
Sources: CMS HCPCS Level II release October 2025; 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.