AFINITOR J Code: J7527

Drug & Product Overview

HCPCS Descriptor Everolimus, oral, 0.25 mg

HCPCS Added Date January 1, 2013

Manufacturer Multiple Manufacturers

Route of Administration Oral

Generic Status Multi-Source; Generic

Dosage Form Not Available | Tablet | Tablet, For Suspension

About AFINITOR

Afinitor is a medication aligned to the HCPCS J Code: J7527 for billing, pricing, and reimbursement purposes in the United States. This Oncology medication is administered via the oral route and manufactured by multiple companies.

According to CMS Drug Use Information: Everolimus is used with other medications (such as cyclosporine) to prevent rejection of a kidney transplant. Everolimus is also used with other medications (such as tacrolimus) to prevent rejection of a liver transplant. This medication belongs to a class of drugs known as immunosuppressants. It works by weakening your body's defense system (immune system) to help your body accept the new organ as if it were your own.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. Showing 5 of 104 NDCs — log in for the full crosswalk.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
00054-0470-21	Everolimus	Hikma Pharmaceuticals USA Inc.	60	.25 MG
00078-0414-20	Zortress	Novartis Pharmaceuticals Corporation	120	.5 MG
49884-0158-02	Everolimus	Par Health USA, LLC	60	.25 MG
51991-0379-06	Everolimus	Breckenridge Pharmaceutical, Inc.	60	.25 MG
67877-0718-31	Everolimus	Ascend Laboratories, LLC	60	.25 MG
•••••-••••-•• Log in to view	AFINITOR
	AFINITOR
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AFINITOR Pricing & Reimbursement

J7527 Private Payer Reimbursement

$1.23 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

AFINITOR Medically Unlikely Edits (MUE)

The most billing units of J7527 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.25 mg.

Practitioner Office & Hospital Outpatient

40 units / day

= 10 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

Not on the CMS JW / JZ list

CMS does not include Afinitor (J7527) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J7527. Wastage billing guide →

AFINITOR Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Hormone Receptor-Positive, HER2-Negative Breast Cancer Neuroendocrine Tumors (NET) Neuroendocrine Tumors (NET) of pancreatic origin (PNET), unresectable, locally advanced or metastatic Prophylaxis of Organ Rejection in Kidney Transplantation Prophylaxis of Organ Rejection in Liver Transplantation Renal Cell Carcinoma Renal Cell Carcinoma (RCC) TSC-Associated Partial-Onset Seizures TSC-Associated Renal Angiomyolipoma TSC-Associated Subependymal Giant Cell Astrocytoma (SEGA) Tuberous Sclerosis Complex (TSC)-Associated Partial-Onset Seizures Tuberous Sclerosis Complex (TSC)-Associated Renal Angiomyolipoma Tuberous Sclerosis Complex (TSC)-Associated Subependymal Giant Cell Astrocytoma (SEGA) Well-differentiated, non-functional Neuroendocrine Tumors (NET) of gastrointestinal or lung origin, unresectable, locally advanced or metastatic

Drug Class

Cytochrome P450 2D6 Inhibitors [MoA]Cytochrome P450 3A4 Inhibitors [MoA]Decreased Immunologic Activity [PE]Kinase Inhibitor [EPC]Protein Kinase Inhibitors [MoA]mTOR Inhibitor Immunosuppressant [EPC]mTOR Inhibitors [MoA]

Frequently Asked Questions

Is there an available Afinitor billing and coding guide?

Our team has not identified a manufacturer-published source of billing and coding information for AFINITOR.

Are there any available Afinitor patient assistance programs?

Our team has not identified a manufacturer-published source of patient assistance information for AFINITOR.

Where can I find Afinitor prescribing information?

AFINITOR prescribing information can be found at the link below. Please reach out to us if you believe this information to be innacurate or out of date. Visit Here →

Where can I find Afinitor side effect information?

Our team has not yet identified a source of side effects information for AFINITOR. Please check back in a few weeks.

Does billing AFINITOR require JZ/JW wastage modifiers?

CMS does not include AFINITOR (J7527) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J7527. For more information, visit the link below.

About BuyandBill.com:

The BuyandBill.com team is dedicated to delivering high-quality coding and billing information for office-administered drugs. We continuously research HCPCS-coded medications to expand our resources and ensure data accuracy. Manufacturers: click here to sponsor your medication, and we will ensure the most accurate and detailed information is displayed.