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J1323 HCPCS Level II Code: Injection, elranatamab-bcmm, 1 mg

Medicare Coverage & Payment

  • CMS short descriptor: Inj, elranatamab-bcmm, 1 mg
  • Medicare coverage: Carrier judgment (CMS coverage code C)
  • Payment category: Drugs (pricing indicator 51)
  • BETOS: O1D — Chemotherapy
  • Last CMS action effective: April 1, 2024

Source: CMS HCPCS Level II release. Coverage codes indicate how Medicare treats the code, not whether a specific claim will be paid; payer policy and documentation still govern.

Code Overview

Injection, elranatamab-bcmm, 1 mg is a HCPCS Level II code (J1323). CMS assigns coverage code C — Carrier judgment. Short description: Inj, elranatamab-bcmm, 1 mg.

Summary composed by MedCoder from this code's official HCPCS Level II record. The tabular instructional notes themselves appear verbatim below.

Change history

  • 2024-04-01
    Added to the code set
    Injection, elranatamab-bcmm, 1 mg

Drug products (NDC)

CMS ASP NDC-HCPCS Crosswalk · 2026 Q3

Medicare Part B payment limit (ASP + 6%): $192.48

00069-2522-02 — Elrexfio — Pfizer Inc (size 1.1 × qty 1 (1 MG per billing unit))

00069-4494-02 — Elrexfio — Pfizer Inc (size 1.9 × qty 1 (1 MG per billing unit))

From the CMS ASP NDC-HCPCS Crosswalk and Part B Payment Limit File. Payment limits apply per HCPCS billing code, not per package.

Contextual Map

Every relationship of J1323 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Nearest codes (20)

  • J1300 — Injection, eculizumab, 10 mg [Sibling]
  • J1301 — Injection, edaravone, 1 mg [Sibling]
  • J1302 — Injection, sutimlimab-jome, 10 mg [Sibling]
  • J1303 — Injection, ravulizumab-cwvz, 10 mg [Sibling]
  • J1304 — Injection, tofersen, 1 mg [Sibling]
  • J1305 — Injection, evinacumab-dgnb, 5mg [Sibling]
  • J1306 — Injection, inclisiran, 1 mg [Sibling]
  • J1307 — Injection, crovalimab-akkz, 10 mg [Sibling]
  • and 12 more

Change history

  • 2024-04-01 — Added to the code set [Change history]

Nearest Codes in This Family

Official HCPCS Level II classifications closest to J1323 in its code family, with their registry titles.

  • J1306 — Injection, inclisiran, 1 mg
  • J1307 — Injection, crovalimab-akkz, 10 mg
  • J1308 — Injection, famotidine, 0.25 mg
  • J1320 — Injection, amitriptyline hcl, up to 20 mg
  • J1322 — Injection, elosulfase alfa, 1 mg
  • J1324 — Injection, enfuvirtide, 1 mg
  • J1325 — Injection, epoprostenol, 0.5 mg
  • J1326 — Injection, zolbetuximab-clzb, 2 mg
  • J1327 — Injection, eptifibatide, 5 mg
  • J1330 — Injection, ergonovine maleate, up to 0.2 mg