J9317 — Injection, sacituzumab govitecan-hziy, 2.5 mg
J9317 is a HCPCS Level II code for injection, sacituzumab govitecan-hziy, 2.5 mg. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of J9317 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 648 units MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 648 units MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for J9317
- Long descriptor
- Injection, sacituzumab govitecan-hziy, 2.5 mg
- Short descriptor
- Sacituzumab govitecan-hziy
- Added
- January 1, 2021
- BETOS
- O1D
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to J9317
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J9317 is not quite right, the correct code is very often within a few positions of it.
- J9309Injection, polatuzumab vedotin-piiq, 1 mg
- J9310Injection, rituximab, 100 mgterminated
- J9311Injection, rituximab 10 mg and hyaluronidase
- J9312Injection, rituximab, 10 mg
- J9313Injection, moxetumomab pasudotox-tdfk, 0.01 mg
- J9314Injection, pemetrexed (teva), not therapeutically equivalent to j9305, 10 mg
- J9315Injection, romidepsin, 1 mgterminated
- J9316Injection, pertuzumab, trastuzumab, and hyaluronidase-zzxf, per 10 mg
- J9318Injection, romidepsin, non-lyophilized, 0.1 mg
- J9319Injection, romidepsin, lyophilized, 0.1 mg
- J9320Injection, streptozocin, 1 gram
- J9321Injection, epcoritamab-bysp, 0.16 mg
- J9322Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg
- J9323Injection, pemetrexed ditromethamine, 10 mg
- J9324Injection, pemetrexed (pemrydi rtu), 10 mg
- J9325Injection, talimogene laherparepvec, per 1 million plaque forming units
Questions about J9317
What is HCPCS code J9317?
J9317 is a HCPCS Level II code for injection, sacituzumab govitecan-hziy, 2.5 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J9317?
The CMS HCPCS file marks J9317 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is J9317 paid under the physician fee schedule?
J9317 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).