J9400 HCPCS code: Injection, ziv-aflibercept, 1 mg
J9400 is the HCPCS Level II code for injection, ziv-aflibercept, 1 mg. In 2024 Medicare paid an average of $5.16 per service for J9400 across 20,900 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 500 per day on outpatient hospital claims. Medicare volume fell 85% from 2022 to 2024 (137,103 to 20,900 services). In 2024, about 22 clinicians billed Medicare for J9400 for 18 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 | 2014-01-01 |
| Last action effective | 2014-01-01 |
Who bills J9400 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 22 |
| Medicare beneficiaries | 18 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9400, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 137,103 | 77 | $7.64 | $6.10 |
| 2023 | 65,073 | 42 | $6.80 | $5.42 |
| 2024 | 20,900 | 18 | $6.47 | $5.16 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 500 | Clinical: Data |
| practitioner claims | 500 | Clinical: Data |
What changed for J9400
- 2014-01-01: J9400 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 J9400?
J9400 is the HCPCS Level II code for injection, ziv-aflibercept, 1 mg. Short descriptor: "Inj, ziv-aflibercept, 1mg".
How much does Medicare pay for J9400?
In 2024, the average Medicare payment was $5.16 per service (average allowed $6.47).
Does Medicare cover J9400?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9400 can be billed per day?
500 on outpatient hospital claims; 500 on practitioner claims (NCCI medically unlikely edits).
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Next steps
- Run a reimbursement report for a device billed under J9400
- Watch J9400 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9400
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.