J9173 HCPCS code: Injection, durvalumab, 10 mg
J9173 is the HCPCS Level II code for injection, durvalumab, 10 mg. In 2024 Medicare paid an average of $62.94 per service for J9173 across 3,686,905 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 150 per day on outpatient hospital claims. Medicare volume rose 34% from 2022 to 2024 (2,746,557 to 3,686,905 services). In 2024, about 3,250 clinicians billed Medicare for J9173 for 5,256 beneficiaries; Florida, Texas, California accounted for 35% 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 | 2019-01-01 |
| Last action effective | 2019-01-01 |
Who bills J9173 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 3,250 |
| Medicare beneficiaries | 5,256 |
| States with claims | 43 |
| Share of services in top 3 states (Florida, Texas, California) | 35% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9173, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,746,557 | 3,962 | $75.74 | $60.44 |
| 2023 | 3,464,120 | 4,862 | $76.88 | $61.25 |
| 2024 | 3,686,905 | 5,256 | $79.01 | $62.94 |
States with the most J9173 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 496,173 | $63.20 |
| Texas | 440,517 | $63.18 |
| California | 330,119 | $62.75 |
| Illinois | 187,047 | $62.93 |
| Virginia | 177,943 | $63.68 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 150 | Prescribing Information |
| practitioner claims | 150 | Prescribing Information |
What changed for J9173
- 2019-01-01: J9173 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 J9173?
J9173 is the HCPCS Level II code for injection, durvalumab, 10 mg. Short descriptor: "Inj., durvalumab, 10 mg".
How much does Medicare pay for J9173?
In 2024, the average Medicare payment was $62.94 per service (average allowed $79.01).
Does Medicare cover J9173?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9173 can be billed per day?
150 on outpatient hospital claims; 150 on practitioner claims (NCCI medically unlikely edits).
Related J91 codes
- J9100 — Injection, cytarabine, 100 mg
- J9118 — Injection, calaspargase pegol-mknl, 10 units
- J9119 — Injection, cemiplimab-rwlc, 1 mg
- J9120 — Injection, dactinomycin, 0.5 mg
- J9130 — Dacarbazine, 100 mg
- J9144 — Injection, daratumumab, 10 mg and hyaluronidase-fihj
- J9145 — Injection, daratumumab, 10 mg
- J9150 — Injection, daunorubicin, 10 mg
- J9151 — Injection, daunorubicin citrate, liposomal formulation, 10 mg
- J9153 — Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
- J9155 — Injection, degarelix, 1 mg
- J9160 — Injection, denileukin diftitox, 300 micrograms
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 J9173
- Watch J9173 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9173
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.