J9176 HCPCS code: Injection, elotuzumab, 1 mg
J9176 is the HCPCS Level II code for injection, elotuzumab, 1 mg. In 2024 Medicare paid an average of $5.81 per service for J9176 across 4,413,566 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 3000 per day on outpatient hospital claims. Medicare volume fell 31% from 2022 to 2024 (6,429,825 to 4,413,566 services). In 2024, about 794 clinicians billed Medicare for J9176 for 435 beneficiaries; Florida, California, Illinois accounted for 36% 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 | 2017-01-01 |
| Last action effective | 2017-01-01 |
Who bills J9176 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 794 |
| Medicare beneficiaries | 435 |
| States with claims | 15 |
| Share of services in top 3 states (Florida, California, Illinois) | 36% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9176, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 6,429,825 | 623 | $6.75 | $5.39 |
| 2023 | 5,385,781 | 535 | $6.95 | $5.54 |
| 2024 | 4,413,566 | 435 | $7.30 | $5.81 |
States with the most J9176 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 435,141 | $5.79 |
| California | 434,154 | $5.86 |
| Illinois | 269,100 | $5.87 |
| Maryland | 259,264 | $5.52 |
| Tennessee | 219,800 | $5.87 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 3000 | Prescribing Information |
| practitioner claims | 3000 | Prescribing Information |
What changed for J9176
- 2017-01-01: J9176 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 J9176?
J9176 is the HCPCS Level II code for injection, elotuzumab, 1 mg. Short descriptor: "Injection, elotuzumab, 1mg".
How much does Medicare pay for J9176?
In 2024, the average Medicare payment was $5.81 per service (average allowed $7.30).
Does Medicare cover J9176?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9176 can be billed per day?
3000 on outpatient hospital claims; 3000 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
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Next steps
- Run a reimbursement report for a device billed under J9176
- Watch J9176 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9176
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.