J9361 HCPCS code: Injection, efbemalenograstim alfa-vuxw, 0.5 mg

J9361 is the HCPCS Level II code for injection, efbemalenograstim alfa-vuxw, 0.5 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 40 per day on DME suppliers.

Code details

FieldValue
SectionJ codes — Drugs administered other than oral method
Coverage codeC — Carrier judgment
Pricing indicator51 — Drug or biological (priced per ASP/average sales price rules)
BETOS categoryO1E — Other drugs
Added2024-07-01
Last action effective2024-07-01

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
DME suppliers40Prescribing Information
outpatient hospital claims40Prescribing Information
practitioner claims40Prescribing Information

What changed for J9361

Frequently asked questions

What is HCPCS code J9361?

J9361 is the HCPCS Level II code for injection, efbemalenograstim alfa-vuxw, 0.5 mg. Short descriptor: "Inj, efbemalenograstim alfa-".

Does Medicare cover J9361?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

How many units of J9361 can be billed per day?

40 on DME suppliers; 40 on outpatient hospital claims; 40 on practitioner claims (NCCI medically unlikely edits).

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Next steps

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.

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