J9353 HCPCS code: Injection, margetuximab-cmkb, 5 mg
J9353 is the HCPCS Level II code for injection, margetuximab-cmkb, 5 mg. In 2024 Medicare paid an average of $37.30 per service for J9353 across 46,300 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 450 per day on outpatient hospital claims. Medicare volume fell 4% from 2022 to 2024 (48,308 to 46,300 services). In 2024, about 77 clinicians billed Medicare for J9353 for 47 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 | 2021-07-01 |
| Last action effective | 2021-07-01 |
Who bills J9353 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 77 |
| Medicare beneficiaries | 47 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9353, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 48,308 | 47 | $43.44 | $34.72 |
| 2023 | 58,726 | 50 | $43.48 | $34.65 |
| 2024 | 46,300 | 47 | $46.82 | $37.30 |
States with the most J9353 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 6,730 | $37.19 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 450 | Prescribing Information |
| practitioner claims | 450 | Prescribing Information |
What changed for J9353
- 2021-07-01: J9353 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 J9353?
J9353 is the HCPCS Level II code for injection, margetuximab-cmkb, 5 mg. Short descriptor: "Inj. margetuximab-cmkb, 5 mg".
How much does Medicare pay for J9353?
In 2024, the average Medicare payment was $37.30 per service (average allowed $46.82).
Does Medicare cover J9353?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9353 can be billed per day?
450 on outpatient hospital claims; 450 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 J9353
- Watch J9353 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9353
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.