J9177 HCPCS code: Injection, enfortumab vedotin-ejfv, 0.25 mg
J9177 is the HCPCS Level II code for injection, enfortumab vedotin-ejfv, 0.25 mg. In 2024 Medicare paid an average of $28.48 per service for J9177 across 6,019,150 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 520 per day on outpatient hospital claims. Medicare volume rose 203% from 2022 to 2024 (1,988,851 to 6,019,150 services). In 2024, about 2,239 clinicians billed Medicare for J9177 for 1,961 beneficiaries; Florida, Texas, California 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 | 2020-07-01 |
| Last action effective | 2020-07-01 |
Who bills J9177 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,239 |
| Medicare beneficiaries | 1,961 |
| States with claims | 32 |
| Share of services in top 3 states (Florida, Texas, California) | 36% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9177, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,988,851 | 642 | $30.77 | $24.58 |
| 2023 | 3,114,236 | 1,132 | $33.32 | $26.69 |
| 2024 | 6,019,150 | 1,961 | $35.31 | $28.48 |
States with the most J9177 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 882,496 | $28.53 |
| Texas | 640,256 | $28.44 |
| California | 553,482 | $28.37 |
| Arizona | 280,164 | $28.64 |
| Virginia | 266,816 | $28.53 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 520 | CMS Policy |
| practitioner claims | 520 | CMS Policy |
What changed for J9177
- 2020-07-01: J9177 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 J9177?
J9177 is the HCPCS Level II code for injection, enfortumab vedotin-ejfv, 0.25 mg. Short descriptor: "Inj enfort vedo-ejfv 0.25mg".
How much does Medicare pay for J9177?
In 2024, the average Medicare payment was $28.48 per service (average allowed $35.31).
Does Medicare cover J9177?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9177 can be billed per day?
520 on outpatient hospital claims; 520 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 J9177
- Watch J9177 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9177
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.