J9317 HCPCS code: Injection, sacituzumab govitecan-hziy, 2.5 mg
J9317 is the HCPCS Level II code for injection, sacituzumab govitecan-hziy, 2.5 mg. In 2024 Medicare paid an average of $26.64 per service for J9317 across 2,810,827 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 648 per day on outpatient hospital claims. Medicare volume rose 37% from 2022 to 2024 (2,046,262 to 2,810,827 services). In 2024, about 1,634 clinicians billed Medicare for J9317 for 1,161 beneficiaries; California, Florida, Texas accounted for 38% 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 | 2021-01-01 |
| Last action effective | 2021-01-01 |
Who bills J9317 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,634 |
| Medicare beneficiaries | 1,161 |
| States with claims | 30 |
| Share of services in top 3 states (California, Florida, Texas) | 38% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9317, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,046,262 | 851 | $30.88 | $24.66 |
| 2023 | 2,739,562 | 1,157 | $32.12 | $25.59 |
| 2024 | 2,810,827 | 1,161 | $33.43 | $26.64 |
States with the most J9317 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 374,217 | $26.70 |
| Florida | 319,143 | $26.82 |
| Texas | 306,714 | $26.10 |
| Illinois | 150,458 | $26.97 |
| Maryland | 135,556 | $26.30 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 648 | CMS Policy |
| practitioner claims | 648 | CMS Policy |
What changed for J9317
- 2021-01-01: J9317 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 J9317?
J9317 is the HCPCS Level II code for injection, sacituzumab govitecan-hziy, 2.5 mg. Short descriptor: "Sacituzumab govitecan-hziy".
How much does Medicare pay for J9317?
In 2024, the average Medicare payment was $26.64 per service (average allowed $33.43).
Does Medicare cover J9317?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9317 can be billed per day?
648 on outpatient hospital claims; 648 on practitioner claims (NCCI medically unlikely edits).
Related J93 codes
- J9300 — Injection, gemtuzumab ozogamicin, 5 mg
- J9301 — Injection, obinutuzumab, 10 mg
- J9302 — Injection, ofatumumab, 10 mg
- J9303 — Injection, panitumumab, 10 mg
- J9304 — Injection, pemetrexed (pemfexy), 10 mg
- J9305 — Injection, pemetrexed, not otherwise specified, 10 mg
- J9306 — Injection, pertuzumab, 1 mg
- J9307 — Injection, pralatrexate, 1 mg
- J9308 — Injection, ramucirumab, 5 mg
- J9309 — Injection, polatuzumab vedotin-piiq, 1 mg
- J9310 — Injection, rituximab, 100 mg
- J9311 — Injection, rituximab 10 mg and hyaluronidase
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Next steps
- Run a reimbursement report for a device billed under J9317
- Watch J9317 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9317
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.