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HCPCS J9062 · Level II · Part B drug

HCPCS J9062: Injection, amivantamab 5 mg and hyaluronidase-lpuj

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for J9062

Billing unit
5 MG
Inj amivantamab 5mg hyaluron
ASP payment limit
$40.492
October 2026; -0.6% vs July 2026
Practitioner MUE
none published
CMS publishes no MUE for this code
OPPS status
SI G
APC 0942
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J9062 is the Level II code for Injection, amivantamab 5 mg and hyaluronidase-lpuj, billed per 5 MG. The Medicare Part B ASP payment limit for October 2026 is $40.492 per billing unit, down 0.6% from July 2026. Under OPPS it carries status indicator G in APC 0942. J9062 is billed in units of 5 MG; the quantity administered, the NDC package and the units on the claim must reconcile, which is the check that prevents CARC 16 and 151 returns on this line. The ASP crosswalk maps 4 NDCs to it, sold as Rybrevant Faspro by Janssen Biotech, Inc.. No current Billing and Coding Article lists J9062, so coverage follows the FDA label, compendia and any applicable NCD.

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J9062 at $40.492 per 5 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $40.743 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J9062
QuarterPayment limitPerCoinsurance
October 2026$40.4925 MG20%
July 2026$40.7435 MG—
Source: CMS Medicare Part B Drug Payment Limit File. Commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 4 NDCs from 1 labeler to J9062. Report the NDC in the claim's drug segment and bill the number of J9062 units that equals the quantity administered divided by 5 MG; the last column gives units per full package.

NDCs that crosswalk to J9062
NDCDrug nameLabelerPackage sizeBilling units / package
57894-0510-01Rybrevant FasproJanssen Biotech, Inc.10 × 1320
57894-0514-01Rybrevant FasproJanssen Biotech, Inc.14 × 1448
57894-0515-01Rybrevant FasproJanssen Biotech, Inc.15 × 1480
57894-0522-01Rybrevant FasproJanssen Biotech, Inc.22 × 1704

Medically Unlikely Edits (MUE)

CMS does not publish an MUE for J9062 in the 2026 Q4 tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the dose and the units calculation on every claim.

NCCI edits and add-on relationships

No active practitioner PTP pair lists J9062 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

J9062 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

No current Billing and Coding Article lists J9062 in its HCPCS table. Coverage then follows the drug's FDA label, compendia and any National Coverage Determination; check the Medicare Coverage Database before administering off-label.

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J9062 carries status indicator G and is assigned to APC 0942, with a published national unadjusted payment of $40.74. Status G marks pass-through drug payment, which is time-limited.

Common denials for J9062 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks J9062 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

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Frequently asked questions — HCPCS J9062

What does HCPCS code J9062 describe?

J9062 is defined by CMS as "Injection, amivantamab 5 mg and hyaluronidase-lpuj". Each billing unit represents 5 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J9062 in October 2026?

The ASP-based payment limit is $40.492 per 5 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $40.743.

Which NDCs map to J9062?

The October 2026 ASP crosswalk lists 4 NDCs from 1 labeler: Rybrevant Faspro (Janssen Biotech, Inc.). For example NDC 57894-0510-01 is a 10 package equal to 320 billing units. The crosswalk's billing-units-per-package figure converts each package into J9062 units.

Does J9062 have NCCI bundling edits?

No active practitioner PTP pairs list J9062 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.