MARGENZA J Code: J9353

Drug & Product Overview

HCPCS Descriptor Injection, margetuximab-cmkb, 5 mg

HCPCS Added Date July 1, 2021

Manufacturer MacroGenics

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Solution, Concentrate

About MARGENZA

Margenza is a medication aligned to the HCPCS J Code: J9353 for billing, pricing, and reimbursement purposes in the United States. Classified under Oncology, it is administered via the intravenous route and manufactured by MacroGenics.

According to CMS Drug Use Information: Margetuximab is used along with other medication(s) to treat breast cancer. Margetuximab belongs to a class of drugs known as monoclonal antibodies. It 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
74527-0022-02	Margenza	MacroGenics, Inc	50	250 MG / 10 ML
74527-0022-03	Margenza	MacroGenics, Inc	200	250 MG / 10 ML

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MARGENZA Pricing & Reimbursement

J9353 Private Payer Reimbursement

$55.27 / 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

MARGENZA Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 27.08%

Avg. Days to File 16.6days

Avg. Days to Pay 31.2days

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

Explore J9353 claims analytics on FocalPoint →

MARGENZA 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 Margenza (J9353) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

MARGENZA Medically Unlikely Edits (MUE)

The most billing units of J9353 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 5 mg.

Practitioner Office & Hospital Outpatient

450 units / day

= 2,250 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 →

MARGENZA 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.

metastatic HER2-positive breast cancer

Drug Class

HER2/Neu/cerbB2 Antagonists [MoA]HER2/neu Receptor Antagonist [EPC]

Frequently Asked Questions

Is there an available Margenza billing and coding guide?

Billing and coding information for MARGENZA can be found through MacroGenics. Visit Here →

Are there any available Margenza patient assistance programs?

MARGENZA patient assistance information can be found through MacroGenics. Visit Here →

Where can I find Margenza prescribing information?

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

Where can I find Margenza side effect information?

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

Does billing MARGENZA require JZ/JW wastage modifiers?

CMS has identified MARGENZA(J9353) 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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