J9286 HCPCS code: Injection, glofitamab-gxbm, 2.5 mg
J9286 is the HCPCS Level II code for injection, glofitamab-gxbm, 2.5 mg. In 2024 Medicare paid an average of $2,158.06 per service for J9286 across 1,846 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 12 per day on outpatient hospital claims. In 2024, about 79 clinicians billed Medicare for J9286 for 33 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 | 2024-01-01 |
| Last action effective | 2024-01-01 |
Who bills J9286 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 79 |
| Medicare beneficiaries | 33 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9286, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 1,846 | 33 | $2,708.58 | $2,158.06 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 12 | Prescribing Information |
| practitioner claims | 12 | Prescribing Information |
What changed for J9286
- 2024-01-01: J9286 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 J9286?
J9286 is the HCPCS Level II code for injection, glofitamab-gxbm, 2.5 mg. Short descriptor: "Inj glofitamab gxbm, 2.5 mg".
How much does Medicare pay for J9286?
In 2024, the average Medicare payment was $2,158.06 per service (average allowed $2,708.58).
Does Medicare cover J9286?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9286 can be billed per day?
12 on outpatient hospital claims; 12 on practitioner claims (NCCI medically unlikely edits).
Related J92 codes
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- J9204 — Injection, mogamulizumab-kpkc, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J9286
- Watch J9286 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9286
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.