HCPCS
J2351
1 billing unit = 1 mg
Ocrevus Zunovo and the injectable MS landscape
The subcutaneous product costs more than the infusion it replaces. J2351 pays $12.91 less per mg than J2350, but the labeled Zunovo dose (920 mg) is much larger than the infusion’s maintenance dose (600 mg), so a year of Zunovo allows $15,266.40 more than a year of the infusion.
| HCPCS | Rate/mg | Dose | Per dose | Per year (2 doses) | |
|---|---|---|---|---|---|
| Ocrevus Zunovo (SC) | J2351 | $48.06 | 920 mg | $44,215.20 | $88,430.40 |
| Ocrevus (IV) | J2350 | $60.97 | 600 mg | $36,582.00 | $73,164.00 |
| Briumvi (IV) | J2329 | $72.239 | 450 mg | $32,507.55 | $65,015.10 |
J2351 is $12.91/mg cheaper than J2350 and still costs $15,266.40 more a year, because the labeled dose is 920 mg against 600 mg. That inverts the usual assumption about a subcutaneous switch. Briumvi (ublituximab-xiiy, TG Therapeutics) is a different molecule, shown here for scale — not a clinical recommendation.
Ocrevus Zunovo vs. Ocrevus IV — same molecule, different claim shape
Zunovo has no loading dose: the first 920 mg injection is identical to every one after it. Infused Ocrevus splits its first dose into two 300 mg infusions 14 days apart — a claim-count difference detailed on the billing units page.
Every billing axis differs between the two products: J-code, NDC, vial size, dose, administration code and injection time. Confirm which formulation the encounter note describes before coding the claim — the unit math (920 vs. 600) is not interchangeable.
Ocrevus Zunovo dosing, workup and duration
One fixed dose, no induction phase, for every labeled indication. The distinction that matters to a biller is not the dose — it is confirming which formulation the encounter note describes.
| Indication | Regimen | Notes |
|---|---|---|
| All labeled indications | 920 mg subcutaneously into the abdomen over about 10 minutes, once every 6 months | One fixed dose for relapsing forms of MS, primary progressive MS and active secondary progressive MS. Not adjusted for weight, BSA or renal function. Each dose is one 920 mg single-dose vial and 920 billing units, drawn whole, so JZ is the modifier on every claim. |
| Switching from Ocrevus IV | 920 mg subcutaneously, given in place of the next scheduled infusion | A patient already established on infused Ocrevus moves straight to the 920 mg subcutaneous dose on their next due date. There is no re-loading and no overlap, so the switch changes the J-code on the claim from J2350 to J2351 and the administration code with it. |
Pre-treatment workup checklist
- Screen for hepatitis B before the first dose; active infection is a contraindication.
- Check immunoglobulins before starting and periodically after, per the label.
- Complete any required live or live-attenuated vaccines at least four weeks before the first dose.
- Confirm the payer’s administration-code position before the first claim: 96401 and 96372 are both in use for this injection and they pay $71.81 and $15.36.
A standing therapy, not a one-off
There is no labeled stopping point. Dosing continues every six months while the patient stays on therapy, which for a chronic MS disease-modifying therapy is usually years — so the per-dose figures on these pages are a standing twice-yearly commitment, not a one-time cost.
Need the billing units for a patient? Convert dose to J2351 billing units →
Ocrevus Zunovo billing reference
HCPCS
J2351 — “Inj ocrelizumab 1mg hya-ocsq,” 1 mg per billing unit. A 920 mg dose is 920 units. Became a permanent J-code effective April 1, 2025.
NDC
NDC 50242-554-01 (10-digit) / 50242-0554-01 (11-digit), Genentech.
| NDC (10-digit) | NDC (11-digit, claim form) | Package |
|---|---|---|
50242-554-01 | 50242-0554-01 | 920 mg ocrelizumab with 23,000 units hyaluronidase-ocsq in 23 mL, single-dose vial |
Administration — the contested code
96401 pays $71.81. 96372 pays $15.36 for the same ten-minute injection. That is a 4.7x spread decided by payer policy, not by what happens in the chair.
| CPT | Description | Use for |
|---|---|---|
96401 | Chemotherapy administration, SC/IM; non-hormonal anti-neoplastic | Genentech’s own billing guidance leads with this code ($71.81, Medicare PFS national non-facility, 2026); used by many payers. |
96372 | Therapeutic, prophylactic or diagnostic injection; subcutaneous or intramuscular | Some payers require this code instead for the same injection ($15.36). |
96413 / 96365 | IV infusion administration | Not appropriate. Zunovo is not infused — these codes belong to the infused product, Ocrevus (J2350). |
This manifest uses 96401, the code Genentech’s billing guidance leads with. The split is real, not settled — confirm the payer’s own position before the first claim. See the billing units page for the units math and what to do about the split.
Modifiers
JZ — required on every claim; there is no routine JW scenario for this product, because the 920 mg single-dose vial matches the labeled dose exactly.
Effective July 1, 2023, CMS requires the JZ modifier on all single-dose container claims when no drug is discarded. Because Ocrevus Zunovo’s one fixed dose (920 mg) exactly matches the one fixed vial size (920 mg), there is nothing left over to waste — append JZ to the J2351 line on every claim.
Modifier 25 — same-day E/M. Append modifier 25 to the same-day E/M code only if a significant, separately identifiable evaluation occurred beyond the routine pre-injection check-in, which is bundled into the administration code.
TB — 340B drug pricing. Hospitals that acquire ocrelizumab through 340B and bill Medicare report the TB modifier, the sole 340B identifier since CMS discontinued JG on January 1, 2025.
Claim form
CMS-1500 / 837P (physician office; POS 11) field map for a J2351 claim.
| Information | CMS-1500 box | Notes |
|---|---|---|
| NDC qualifier + 11-digit NDC + UoM + qty | 24A shaded area | Format: N4 qualifier + 11-digit NDC + UN + quantity drawn (1 vial) |
| HCPCS J2351 + JZ | 24D (drug line) | 920 units, per MAC rounding |
| CPT 96401 (or 96372) | 24D (admin line) | One line — confirm the payer’s position first |
| ICD-10 | 21 | Indication-specific — see Coverage; the bare G35 is not billable |
| NPI | 17b / 24J / 33a | Rendering and billing provider NPI |
| PA number (when required) | 23 | 24 prior-authorization rules exist across the 27-payer ocrelizumab corpus |
| TB modifier (340B sites only) | 24D | Hospital outpatient 340B claims only |
Ocrevus Zunovo coverage
- 23 of 27 commercial payer policy sets require prior authorization
- 0 name a preferred ocrelizumab and hyaluronidase-ocsq product
- 19 rules address dosing, 15 carry contraindication exclusions, 11 set a site-of-care rule, 6 set a quantity limit and 4 require reauthorization
- Indication keys in the rules:
multiple_sclerosis(76 rules) andprimary_progressive_multiple_sclerosis(52 rules) - Because Ocrevus Zunovo and infused Ocrevus share one molecule under this corpus, a payer’s policy may set rules by indication rather than by formulation — verify the diagnosis on file as well as the J-code
ICD-10 codes by indication
Verified against the NLM Clinical Table Search Service, 2026-09-13. The bare G35 is not billable.
| Indication | ICD-10 | Notes |
|---|---|---|
| Relapsing forms of multiple sclerosis | G35.A | Relapsing-remitting MS |
| Primary progressive multiple sclerosis | G35.B1 | Active. G35.B0 (unspecified) and G35.B2 (non-active) also exist |
| Active secondary progressive multiple sclerosis | G35.C1 | G35.C0 (unspecified) and G35.C2 (non-active) also exist |
| Multiple sclerosis, unspecified | G35.D | Use only when the record does not support a more specific code above |
G35 alone was expanded and is no longer billable. Claims carrying the parent code alone are rejected. No effective date for the expansion is stated here; it could not be confirmed against a primary source.
Check the patient’s actual policy: See Ocrevus Zunovo coverage by payer →
Full FDA-indicated Medicare reference: Medicare covered diagnoses for Ocrevus Zunovo →
Current Ocrevus Zunovo pricing
Medicare ASP+6%: $48.060 / 1 mg · $44,215.20 / 920 mg. Add the $71.81 administration allowance for 96401 and the claim totals $44,287.01 before the sequester.
Sequestration reduces Medicare’s 80% share by 2%. Commercial plans pay a contracted rate that differs by payer and state.
2 doses a year (920 mg SC every 6 months) at $44,287.01 per dose — drug plus 96401 administration — total $88,574.02 before the sequester. That is the full annual drug-plus-administration cost for a patient staying on schedule, before benefits or assistance.
Patient cost
The patient’s actual responsibility depends on: payer allowed rate · remaining Part B deductible ($283 in 2026) · benefits · − assistance · = patient responsibility. At 20% coinsurance with the deductible already met, a Medicare patient’s share of one dose is $8,857.40.
Medigap changes the answer on a claim this size. A Plan K patient (50% coinsurance coverage, $8,000 annual out-of-pocket cap) pays $4,683.40 at the first dose, with the deductible still unmet, and reaches $9,112.10 cumulative at the second — so the $8,000 cap is crossed on dose two of this twice-yearly drug, every year. After that the plan pays the rest of the year’s claims in full.
Calculate an Ocrevus Zunovo patient estimate →
Copay & financial assistance
A commercially insured patient can reach $0 for the drug and $0 for the injection, on two separate caps: $20,000 a calendar year for the drug and $1,500 for administration in the first year. Both programs are scoped to Zunovo specifically — infused Ocrevus (J2350) carries its own separate programs, so confirm the program covers the formulation actually billed before pointing a patient to it.
Common Ocrevus Zunovo denials & fixes
| Denial reason | Common cause | Fix |
|---|---|---|
| Wrong administration code | 96401 billed for a payer that requires 96372, or vice versa | Confirm the payer’s position before resubmission; both codes are genuinely in use for this injection. |
| Wrong J-code (J2351 vs. J2350) | Encounter note does not clearly state subcutaneous vs. infused administration | Confirm the formulation in the note; the unit count differs, 920 vs. 600. |
| Bare G35 submitted | Parent ICD-10 code used instead of a billable subtype | Resubmit with the specific subtype: G35.A, G35.B0–B2, G35.C0–C2 or G35.D. |
| JZ missing | Single-dose-vial claim without JZ when no drug was discarded | Resubmit with JZ on the drug line — the norm on every Zunovo claim. |
| PA missing | Claim submitted without prior authorization | Submit PA before the next scheduled dose; 24 of the corpus’s 251 rules require it. |
| Diagnosis mismatch under a shared molecule | ICD-10 on file does not match an MS indication in the covered-indication rules | Confirm the diagnosis on file supports the indication billed, regardless of which formulation (J2350 or J2351) was given. |
Frequently asked questions
What is the HCPCS code for Ocrevus Zunovo?
J2351. It bills 1 unit per 1 mg, so the labeled 920 mg dose is 920 units. That single line prices at $44,215.20 — the most expensive claim on this site, ahead of Keytruda’s $12,129.
What is the dosing for ocrelizumab and hyaluronidase-ocsq by indication?
There is no induction phase and only one dose — 920 mg every 6 months — whether this is a patient’s first dose or a switch from the infused product:
- Every labeled indication = 920 mg every 26 weeks
- Patients switching from the infusion = 920 mg every 26 weeks
That single dose covers relapsing forms of MS, primary progressive MS and active secondary progressive MS. It is fixed and is not adjusted for weight, body surface area, or renal function.
Why does the subcutaneous product cost more than the Ocrevus infusion it replaces?
J2351 pays $48.06 per mg, $12.91 less than J2350’s $60.97. But the labeled Zunovo dose is 920 mg against the infusion’s 600 mg, so a year of Zunovo allows $88,430.40 against $73,164.00 for the infusion — $15,266.40 more a year.
Which administration code applies to Ocrevus Zunovo, 96401 or 96372?
Both are in use for the same ten-minute subcutaneous injection. 96401 pays $71.81 and 96372 pays $15.36 — a 4.7x spread set by payer policy, not by what happens in the chair. Confirm the payer’s position before the first claim.
What ICD-10 code covers Ocrevus Zunovo?
Not the bare G35 — it is not billable. Relapsing forms use G35.A, primary progressive MS uses G35.B0, G35.B1 or G35.B2, and secondary progressive MS uses G35.C0, G35.C1 or G35.C2; unspecified MS uses G35.D.
Sources
- AAPC — HCPCS J2351 (Ocrevus Zunovo)
- AAPC — HCPCS J2350 (Ocrevus)
- AAPC — HCPCS J2329 (Briumvi)
- DailyMed — Ocrevus Zunovo prescribing information
- NLM Clinical Table Search Service — ICD-10-CM (G35 expansion, verified 2026-09-13)
- CMS — Medicare Part B Drug ASP Pricing File
- CMS — HCPCS quarterly update file
- CMS — JW / JZ modifier guidance
Dataset dates: pricing Q3 2026 · payer policies Aug 2026 · assistance Jul 2026.
Reviewed September 13, 2026 by Erin Rose, CareCost Estimate founder. Methodology →