J9063 HCPCS code: Injection, mirvetuximab soravtansine-gynx, 1 mg
J9063 is the HCPCS Level II code for injection, mirvetuximab soravtansine-gynx, 1 mg. In 2024 Medicare paid an average of $51.63 per service for J9063 across 938,572 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 900 per day on outpatient hospital claims. Medicare volume rose 145% from 2023 to 2024 (382,749 to 938,572 services). In 2024, about 744 clinicians billed Medicare for J9063 for 503 beneficiaries; California, Florida, Texas accounted for 53% 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 | O1D — Chemotherapy |
| Added | 2023-07-01 |
| Last action effective | 2023-07-01 |
Who bills J9063 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 744 |
| Medicare beneficiaries | 503 |
| States with claims | 11 |
| Share of services in top 3 states (California, Florida, Texas) | 53% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9063, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 382,749 | 264 | $64.45 | $51.35 |
| 2024 | 938,572 | 503 | $64.81 | $51.63 |
States with the most J9063 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 134,425 | $51.81 |
| Florida | 132,324 | $51.60 |
| Texas | 106,916 | $50.88 |
| Illinois | 71,000 | $51.84 |
| Maryland | 48,027 | $50.74 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 900 | Prescribing Information |
| practitioner claims | 900 | Prescribing Information |
What changed for J9063
- 2023-07-01: J9063 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 J9063?
J9063 is the HCPCS Level II code for injection, mirvetuximab soravtansine-gynx, 1 mg. Short descriptor: "Inj, elahere, 1 mg".
How much does Medicare pay for J9063?
In 2024, the average Medicare payment was $51.63 per service (average allowed $64.81).
Does Medicare cover J9063?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9063 can be billed per day?
900 on outpatient hospital claims; 900 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
- J9023 — Injection, avelumab, 10 mg
- J9024 — Injection, atezolizumab, 5 mg and hyaluronidase-tqjs
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Next steps
- Run a reimbursement report for a device billed under J9063
- Watch J9063 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9063
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.