Enhertu J Code: J9358

Drug & Product Overview

HCPCS Descriptor Injection, fam-trastuzumab deruxtecan-nxki, 1 mg

HCPCS Added Date July 1, 2020

Manufacturer Daiichi Sankyo

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Powder, Lyophilized, For Solution

About Enhertu

Enhertu is a medication aligned to the HCPCS J Code: J9358 for billing, pricing, and reimbursement purposes in the United States. It is an Oncology drug administered via the intravenous route and manufactured by Daiichi Sankyo.

According to CMS Drug Use Information: Trastuzumab deruxtecan is used to treat certain types of cancer (such as breast cancer, lung cancer, stomach cancer, esophageal cancer, certain other solid tumors). This medication is called a monoclonal antibody and topoisomerase inhibitor conjugate. Trastuzumab deruxtecan 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
65597-0406-01	Enhertu	Daiichi Sankyo Inc.	100	100 MG / 5 ML

Login for the full NDC crosswalk View pricing, complete NDC-to-HCPCS alignments, and package details.

Login →

Enhertu Pricing & Reimbursement

J9358 Private Payer Reimbursement

$32.11 / 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

Enhertu Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 11.14%

Avg. Days to File 8.2days

Avg. Days to Pay 25.6days

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

Explore J9358 claims analytics on FocalPoint →

Enhertu CPT Administration Codes

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 Enhertu (J9358) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

Enhertu Medically Unlikely Edits (MUE)

The most billing units of J9358 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

1,000 units / day

= 1,000 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 →

Enhertu 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.

HER2-Low and HER2-Ultralow Metastatic Breast Cancer HER2-Mutant Unresectable or Metastatic Non-Small Cell Lung Cancer HER2-Positive (IHC 3+) Unresectable or Metastatic Solid Tumors HER2-Positive Early Breast Cancer HER2-Positive Locally Advanced or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma HER2-Positive Metastatic Breast Cancer

Frequently Asked Questions

Is there an available Enhertu billing and coding guide?

Billing and coding information for Enhertu can be found through Daiichi Sankyo. Visit Here →

Are there any available Enhertu patient assistance programs?

Enhertu patient assistance information can be found through Daiichi Sankyo. Visit Here →

Where can I find Enhertu prescribing information?

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

Where can I find Enhertu side effect information?

Information regarding Enhertu's side effects can be found at MedlinePlus Visit Here →

Does billing Enhertu require JZ/JW wastage modifiers?

CMS has identified Enhertu(J9358) 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.

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.