ELREXFIO J Code: J1323

Drug & Product Overview

HCPCS Descriptor Injection, elranatamab-bcmm, 1 mg

HCPCS Added Date April 1, 2024

Manufacturer Pfizer

Route of Administration Subcutaneous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Solution

About ELREXFIO

Elrexfio is a medication aligned to the HCPCS J Code: J1323 for billing, pricing, and reimbursement purposes in the United States. This Oncology medication is administered via the subcutaneous route and manufactured by Pfizer.

According to CMS Drug Use Information: This medication is used to treat a certain type of cancer (multiple myeloma). Elranatamab 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. Showing 2 of 4 NDCs — log in for the full crosswalk.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
00069-2522-02	Elrexfio	Pfizer Laboratories Div Pfizer Inc	44	44 MG / 1.1 ML
00069-4494-02	Elrexfio	Pfizer Laboratories Div Pfizer Inc	76	76 MG / 1.9 ML
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	ELREXFIO

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ELREXFIO Pricing & Reimbursement

J1323 Private Payer Reimbursement

$194.35 / 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 Q4 2026

ELREXFIO Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 13.82%

Avg. Days to File 5.8days

Avg. Days to Pay 27.6days

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

Explore J1323 claims analytics on FocalPoint →

ELREXFIO CPT Administration Codes

CPT Code	Description
96401	Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic

Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

ELREXFIO Medically Unlikely Edits (MUE)

The most billing units of J1323 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

76 units / day

= 76 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 →

ELREXFIO 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.

relapsed or refractory multiple myeloma

Frequently Asked Questions

Is a Elrexfio billing and coding guide available?

Billing and coding information for ELREXFIO can be found through Pfizer Inc.. Visit Here →

Is Elrexfio patient assistance information available?

ELREXFIO patient assistance information can be found through Pfizer Inc.. Visit Here →

Where can I find Elrexfio prescribing information?

ELREXFIO prescribing information can be found at the link below: Visit Here →

Where can I find Elrexfio side effect information?

Information regarding ELREXFIO's potential side effects can be found at MedlinePlus

Does billing ELREXFIO require JZ/JW wastage modifiers?

CMS does not include ELREXFIO (J1323) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1323. For more information, visit the link below.

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