Home › Drug Codes › J Codes › J9063 · ELAHERE
Updated July 1st, 2026

ELAHERE J Code: J9063

Injection, mirvetuximab soravtansine-gynx, 1 mg

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Q4 2026 Medicare Payment Limit for J9063, effective October 1, 2026: $71.584 per HCPCS billing unit, down 0.6% from $71.991. From CMS's final file.

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Medicare Payment Limit ?
$71.991
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$71.991
/ HCPCS billing unit · APC 9109
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
1
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Drug & Product Overview

HCPCS Descriptor Injection, mirvetuximab soravtansine-gynx, 1 mg
HCPCS Added Date July 1, 2023
Manufacturer Immunogen, Inc.
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Solution

About ELAHERE

Elahere is a medication aligned to the HCPCS J Code: J9063 for billing, pricing, and reimbursement purposes in the United States. This Misc. medication is administered via the intravenous route and manufactured by Immunogen, Inc.

According to CMS Drug Use Information: This medication is used to treat certain cancers (such as epithelial ovarian, fallopian tube, primary peritoneal). Mirvetuximab soravtansine works by slowing or stopping the growth of cancer cells.

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. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
72903-0853-01 Elahere ImmunoGen, Inc. 100 100 MG / 20 ML
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ELAHERE Pricing & Reimbursement

J9063 Private Payer Reimbursement
$73.38 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

ELAHERE Claims Performance

Claims from Jan 2026 – Aug 2026
Claim Denial Rate 9.34%
Avg. Days to File 9.7days
Avg. Days to Pay 28.7days

Real-world claims performance from FocalPoint, OnPoint Oncology's reimbursement analytics platform, with claims data accrued at the clearing house level.

Explore J9063 claims analytics on FocalPoint →
OnPoint Oncology

ELAHERE CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96413 Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415 Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)
JW / JZ modifiers apply

CMS has identified Elahere (J9063) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ELAHERE Medically Unlikely Edits (MUE)

The most billing units of J9063 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient
900 units / day
= 900 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 →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

ELAHERE 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.

folate receptor-alpha (FRα) positive, platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal cancer

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Frequently Asked Questions

Is there an available Elahere billing and coding guide?
Billing and coding information for ELAHERE can be found through Immunogen, Inc.. Visit Here →
Are there any available Elahere patient assistance programs?
ELAHERE patient assistance information can be found through Immunogen, Inc.. Visit Here →
Where can I find Elahere prescribing information?
ELAHERE prescribing information can be found at the link below: Visit Here →
Where can I find Elahere side effect information?
Information regarding ELAHERE's side effects can be found at MedlinePlus Visit Here →
Does billing ELAHERE require JZ/JW wastage modifiers?
CMS has identified ELAHERE(J9063) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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