Urogen

JELMYTO - Cost

Last Updated: April 1st, 2024

HCPCS:

J9281

HCPCS Code Descriptor:

Mitomycin pyelocalyceal instillation, 1 mg

Medicare Payment Limit:

The JELMYTO Medicare Payment Limit is $300.591

Average Sale Price:

JELMYTO ASP cost available once logged in.

Medicare Co-Insurance Percentage:

The JELMYTO Medicare Co-insurance percentage is 20%. JELMYTO's Medicare Co-insurance amount is $60.12 per HCPCS unit.

APC Code:

The Jelmyto APC Code is: 9374

APC Payment Limit:

The APC Payment Limit for JELMYTO is available. Login to view.

Jelmyto Cost Information:

JELMYTO is manufactured by Urogen and is aligned to HCPCS J9281. JELMYTO became effective on January 1, 2021. Prices have historically risen, every six months, by a couple percentage points. At the start of 2024, ASP remained around 5% below WAC.

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Jelmyto’s wholesale acquisition cost (WAC) information was last updated on:
January 1, 2024
Jelmyto’s average wholesale price (AWP) information was last updated on:
January 1, 2024

Jelmyto Cost Graph: