HCPCS Level II J0517: Injection, benralizumab, 1 mg

HCPCS Level II code J0517 represents a billed unit for the monoclonal antibody injection benralizumab, 1 mg, used for targeted biologic therapy; the service type is therapeutic drug administration and the typical site of service is outpatient infusion or injection clinic / physician office where parenteral biologic therapies are administered.

For related coverage guidance, see recent payer policy updates: T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and Romidepsin, Tumor Treatment Fields - Medical Policy, Extracorporeal Photopheresis.

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Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with severe eosinophilic asthma or eosinophilic chronic rhinosinusitis refractory to standard inhaled corticosteroids and bronchodilators who is scheduled to receive subcutaneous benralizumab therapy. The patient presents to an outpatient infusion or injection clinic, allergy/immunology office, or pulmonology clinic for administration of J0517 (benralizumab, 1 mg). The clinical workflow includes verification of patient identity and insurance, review of indications and recent clinical status (exacerbation frequency, oral corticosteroid use, blood eosinophil count), documentation of any prior biologic therapy and allergic reactions, and assessment of injection site and vitals. The medication is prepared as the appropriate mg dose (per product dosing schedule), administered subcutaneously, and the patient is observed for immediate hypersensitivity or injection-site reaction per office protocol (commonly 30 minutes for first dose, shorter for maintenance doses if tolerated). Nursing documents lot number, expiration, dose administered, route (subcutaneous), site (e.g., right deltoid), and applicable modifier if required by the payer. Follow-up includes scheduling the next dose per dosing interval and documenting clinical response and any adverse events.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Commonly billed for the act of administering a subcutaneous injection when payer requires a CPT code in addition to the J-code for the drug.
`36415`	Collection of venous blood by venipuncture	Performed before initiation or periodically to obtain blood eosinophil counts or other labs related to biologic therapy monitoring.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Typical E/M level for routine follow-up visits associated with maintenance dosing and monitoring of response or adverse effects.
`99406`	Smoking cessation counseling, intermediate, 3-10 minutes	Behavioral counseling codes may be relevant for patients with asthma where counseling is provided during visits (ancillary and situational).
`99070`	Supplies and materials (e.g., clinical staff time, equipment) provided by the physician over and above those usually included with the service	Used when additional supplies or special handling for biologic preparation are required.

Related Modifiers

5 rows

Modifier	Description	When to Use
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

Related Provider Taxonomies

8 rows

Taxonomy Code
207RC0000X
207RP1001X
207L00000X
363LF0000X
333600000X
173C00000X
2080I0007X
284300000X

Related Payer Policy Updates

Specialty: Hematology/Oncology1 / 3

10 rows

Policy	Payer	Effective Date
T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and Romidepsin	Mass General Brigham Health Plan	2027-01-04
Tumor Treatment Fields - Medical Policy	Health-New-England	2026-12-01
Extracorporeal Photopheresis	Cigna	2026-11-15
Electric Tumor Treatment Field Therapy (for Tennessee Only)	Colorado Rocky Mountain Health Plans	2026-11-01
Tumor Treating Fields Therapy	premerabluecrossofwashington	2026-11-01
Tumor Treating Fields Therapy	premerabluecrossofwashington	2026-11-01
Omisirge	Cigna	2026-11-01
Hematology - Adzynma	Cigna	2026-10-15
Transcatheter Arterial Chemoembolization for Liver Tumors	premerabluecrossofwashington	2026-10-01
Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bone	premerabluecrossofwashington	2026-10-01

Related Codes

HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

HCPCS Level II J0121: Omadacycline Injection, 1 mg

HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

HCPCS Level II J0122: Injection, eravacycline, 1 mg

HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

HCPCS Level II J0129: Abatacept Injection, 10 mg

HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

HCPCS Level II J0130: Injection abciximab, 10 mg

HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

HCPCS Level II J0131: Injection, Acetaminophen 10 mg

HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

HCPCS Level II J0133: Injection, Acyclovir 5 mg

HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

Showing 1–10 of 991

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Commonly billed for the act of administering a subcutaneous injection when payer requires a CPT code in addition to the J-code for the drug.
`36415`	Collection of venous blood by venipuncture	Performed before initiation or periodically to obtain blood eosinophil counts or other labs related to biologic therapy monitoring.
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Typical E/M level for routine follow-up visits associated with maintenance dosing and monitoring of response or adverse effects.
`99406`	Smoking cessation counseling, intermediate, 3-10 minutes	Behavioral counseling codes may be relevant for patients with asthma where counseling is provided during visits (ancillary and situational).
`99070`	Supplies and materials (e.g., clinical staff time, equipment) provided by the physician over and above those usually included with the service	Used when additional supplies or special handling for biologic preparation are required.

Related Modifiers

5 rows

Modifier	Description	When to Use
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
78	CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…	- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
80	CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…	- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…

Related Provider Taxonomies

8 rows

Taxonomy Code
207RC0000X
207RP1001X
207L00000X
363LF0000X
333600000X
173C00000X
2080I0007X
284300000X

Related Payer Policy Updates

Specialty: Hematology/Oncology1 / 3

10 rows

Policy	Payer	Effective Date
T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and Romidepsin	Mass General Brigham Health Plan	2027-01-04
Tumor Treatment Fields - Medical Policy	Health-New-England	2026-12-01
Extracorporeal Photopheresis	Cigna	2026-11-15
Electric Tumor Treatment Field Therapy (for Tennessee Only)	Colorado Rocky Mountain Health Plans	2026-11-01
Tumor Treating Fields Therapy	premerabluecrossofwashington	2026-11-01
Tumor Treating Fields Therapy	premerabluecrossofwashington	2026-11-01
Omisirge	Cigna	2026-11-01
Hematology - Adzynma	Cigna	2026-10-15
Transcatheter Arterial Chemoembolization for Liver Tumors	premerabluecrossofwashington	2026-10-01
Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bone	premerabluecrossofwashington	2026-10-01

Related Codes

HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

HCPCS Level II J0121: Omadacycline Injection, 1 mg

HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

HCPCS Level II J0122: Injection, eravacycline, 1 mg

HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

HCPCS Level II J0129: Abatacept Injection, 10 mg

HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

HCPCS Level II J0130: Injection abciximab, 10 mg

HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

HCPCS Level II J0131: Injection, Acetaminophen 10 mg

HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

HCPCS Level II J0133: Injection, Acyclovir 5 mg

HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

Showing 1–10 of 991

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

HCPCS Level II J0517: Injection, benralizumab, 1 mg

Sign up for hcpcs J0517 policy alerts

HCPCS Level II J0517: Injection, benralizumab, 1 mg

Sign up for hcpcs J0517 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does HCPCS code J0517 represent?

Where is benralizumab (J0517) typically administered and what is the general clinical workflow?

Which billing modifiers are commonly relevant when billing J0517?

What other CPT codes are commonly billed with J0517?

What diagnoses and clinical documentation are commonly associated with billing J0517?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does HCPCS code J0517 represent?

Where is benralizumab (J0517) typically administered and what is the general clinical workflow?

Which billing modifiers are commonly relevant when billing J0517?

What other CPT codes are commonly billed with J0517?

What diagnoses and clinical documentation are commonly associated with billing J0517?

References