J9325 HCPCS code: Injection, talimogene laherparepvec, per 1 million plaque forming units
J9325 is the HCPCS Level II code for injection, talimogene laherparepvec, per 1 million plaque forming units. In 2024 Medicare paid an average of $53.55 per service for J9325 across 114,225 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 400 per day on outpatient hospital claims. Medicare volume rose 33% from 2022 to 2024 (85,620 to 114,225 services). In 2024, about 83 clinicians billed Medicare for J9325 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 | O1E — Other drugs |
| Added | 2017-01-01 |
| Last action effective | 2017-01-01 |
Who bills J9325 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 83 |
| Medicare beneficiaries | 106 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9325, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 85,620 | 100 | $57.41 | $45.80 |
| 2023 | 79,305 | 81 | $62.69 | $50.03 |
| 2024 | 114,225 | 106 | $66.84 | $53.55 |
States with the most J9325 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 22,323 | $53.28 |
| Texas | 15,316 | $54.05 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 400 | Prescribing Information |
| practitioner claims | 400 | Prescribing Information |
What changed for J9325
- 2017-01-01: J9325 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 J9325?
J9325 is the HCPCS Level II code for injection, talimogene laherparepvec, per 1 million plaque forming units. Short descriptor: "Inj talimogene laherparepvec".
How much does Medicare pay for J9325?
In 2024, the average Medicare payment was $53.55 per service (average allowed $66.84).
Does Medicare cover J9325?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9325 can be billed per day?
400 on outpatient hospital claims; 400 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 J9325
- Watch J9325 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9325
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.