In short

J3405 is the HCPCS Level II code for injection, onasemnogene abeparvovec-brve, per treatment. CMS assigns NDCs for Itvisma to it. The Medicare Part B payment limit is $2,729,937.922 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ3405
Billing unitSee descriptor
Descriptor
Injection, onasemnogene abeparvovec-brve, per treatment
Short descriptor
Inj onase abepar-brve treat
Code set
HCPCS Level II, maintained by CMS
Effective
Jul 1, 2026

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$2,729,937.922
Perper treatment
Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: Added October 2026. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Units and claim line

Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the units to build the claim line.

NDCs billed under J3405

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 1 NDC to J3405 for Itvisma. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J3405 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Itvisma71894-0200-02Novartis Gene Therapies, Inc.31

J3405: common questions

Is J3405 a CPT code?
No. J3405 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under J3405?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 1 NDC under J3405, for Itvisma. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J3405?
$2,729,937.922 per per treatment, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.

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