J9321 HCPCS code: Injection, epcoritamab-bysp, 0.16 mg
J9321 is the HCPCS Level II code for injection, epcoritamab-bysp, 0.16 mg. In 2024 Medicare paid an average of $42.17 per service for J9321 across 323,142 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 300 per day on DME suppliers. In 2024, about 301 clinicians billed Medicare for J9321 for 106 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 J9321 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 301 |
| Medicare beneficiaries | 106 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9321, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 323,142 | 106 | $52.93 | $42.17 |
States with the most J9321 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Minnesota | 49,500 | $41.59 |
| Texas | 40,525 | $42.08 |
| California | 38,473 | $42.38 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 300 | Prescribing Information |
| outpatient hospital claims | 300 | Prescribing Information |
| practitioner claims | 300 | Prescribing Information |
What changed for J9321
- 2024-01-01: J9321 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 J9321?
J9321 is the HCPCS Level II code for injection, epcoritamab-bysp, 0.16 mg. Short descriptor: "Inj epcoritamab-bysp 0.16 mg".
How much does Medicare pay for J9321?
In 2024, the average Medicare payment was $42.17 per service (average allowed $52.93).
Does Medicare cover J9321?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9321 can be billed per day?
300 on DME suppliers; 300 on outpatient hospital claims; 300 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
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 J9321
- Watch J9321 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9321
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.