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J9325

J9325 – Injection, talimogene laherparepvec, per 1 million plaque forming units · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 2 NDCs crosswalked per 1 million PFU $77.339/unit ASP+6%

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Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

📋 J9325 summary

J9325 is a HCPCS Level II J-code used to bill talimogene laherparepvec, per 1 million plaque forming units, billed per 1 million PFU. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.

Brand names associated with J9325: Imlygic

Code J9325 Billing unit 1 million PFU Payment limit $77.339/unit NDC-Crosswalk 2 Quarter Q3 2026 RxCUI Atlas Trace the drug concept →

⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.

🗂️ Key billing facts

HCPCS codeJ9325
DescriptorInjection, talimogene laherparepvec, per 1 million plaque forming units
Billing unit1 million PFU
Payment limit / unit$77.339
Est. ASP / unit$72.961 est.
Mapped NDCs2
Data periodQ3 2026
Last updated2026-08-20

💊 About Talimogene Laherparepvec Injection DRUG GUIDE

Imlygic is used for the local treatment of unresectable cutaneous (skin), subcutaneous (under the skin), and nodal (lymph node) lesions in patients with melanoma that has come back after initial surgery.Important limitation: Imlygic has not been shown to improve overall survival or to affect melanoma that has spread to internal organs (visceral metastases).

Read the full Talimogene Laherparepvec Injection drug guide →
Clinical overview from our editorial drug guide for Talimogene Laherparepvec Injection. For billing reference, see the sections above.

🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026

📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$77.339
Est. ASP / unit
$72.961 est.
Est. after 2% sequester
$75.792
HCPCS dosage
1 million PFU
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionInjection, talimogene laherparepvec, per 1 million plaque forming units
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment groupYY
Action codeN — No maintenance this year
Effective date2017-01-01
Date added2017-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J9325 = 1 million. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.

🔁 NDCs that bill under J9325 WITH EST. MEDICARE PAY

2 NDCs map to J9325. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($77.339/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
55513-0078-01 Imlygic talimogene laherparepvec 1000000 [PFU]/mL INJECTION, SUSPENSION Amgen 1 VIAL in 1 CARTON (55513-078-01) / 1 mL... 1000000 [PFU]/mL 1 $77.34 — ● Active CMS ASP
55513-0079-01 Imlygic talimogene laherparepvec 100000000 [PFU]/mL INJECTION, SUSPENSION Amgen 1 VIAL in 1 CARTON (55513-079-01) / 1 mL... 100000000 [PFU]/mL 100 $7,733.90 — ● Active CMS ASP
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period
Total Part B spend
$6.54M
Claims
503
Beneficiaries
194
Spend / beneficiary
$33,690.65
Spend / claim
$12,994.01
Trend by period
Where J9325 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #213 of 824
#208 PEMFEXY J9304 $7.15M #209 JELMYTO J9281 $7.14M #210 SEVENFACT J7212 $7.11M #211 FYLNETRA Q5130 $6.83M #212 YONDELIS J9352 $6.7M #213 IMLYGIC J9325 $6.54M #214 ISTODAX* J9319 $6.53M #215 DUOPA J7340 $6.53M #216 AVGEMSI J9184 $6.33M #217 CRYSVITA J0584 $6.3M #218 GLASSIA J0257 $6.24M
Total claims — #454 of 824
#449 LEVOFLOXACIN-D5W J1956 524 #450 RISPERDAL CONSTA* J2794 517 #451 ALBUMIN (HUMAN)* P9041 514 #452 BENDAMUSTINE HCL* J9033 507 #453 CEREZYME J1786 506 #454 IMLYGIC J9325 503 #455 MICAFUNGIN(J2248)* J2248 497 #456 ADSTILADRIN J9029 497 #457 XCELL AMNIO MATRIX P... Q4280 495 #458 EPICORD 1 SQ CM** Q4187 490 #459 IMJUDO J9347 489

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $6.54M 194 503 $33,690.65 $12,994.01
2025 (Q1-Q4) $28.35M 426 2,155 $66,542.64 $13,154.14
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.

📈 Medicare Part B claims detail CMS PSPS · 2024

Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$6.13M
Medicare paid
$4.86M
Submitted services
89,700
Denial rate
4.6%
Allowed / service
$71.61
Submitted charges
$15.79M
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.

🗃️ Data sources & freshness

Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk
2 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Not available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.

⚠️ Practical billing caveats

  • A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
  • Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
  • Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
  • Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
  • The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
  • Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.

❓ J9325 billing FAQ

What is HCPCS code J9325?
J9325 is a HCPCS Level II J-code used to bill Injection, talimogene laherparepvec, per 1 million plaque forming units under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J9325?
One unit of J9325 represents 1 million PFU. Report the number of units equal to the dose administered divided by 1 million PFU.
How many units of J9325 should I bill?
Divide the dose administered by the code's unit size (1 million PFU) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J9325?
The Medicare Part B payment limit is $77.339 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $75.792 per unit. Payment limits are revised quarterly.
Which NDCs bill under J9325?
2 NDCs currently map to J9325 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J9325 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.