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HCPCS J9000 · Level II · Part B drug

HCPCS J9000: Injection, doxorubicin hydrochloride, 10 mg

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for J9000

Billing unit
10 MG
Doxorubicin hcl injection
ASP payment limit
$3.12
October 2026; +15.1% vs July 2026
Practitioner MUE
20
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J9000 is the Level II code for Injection, doxorubicin hydrochloride, 10 mg, billed per 10 MG. The Medicare Part B ASP payment limit for October 2026 is $3.12 per billing unit, up 15.1% from July 2026. The practitioner MUE allows up to 20 units per date of service (MAI 3). Under OPPS it carries status indicator N. The 10 mg billing unit means doses are reported in multiples of ten milligrams, with any remainder rounded per contractor policy; mismatched units against the NDC quantity trigger MUE and NDC-unit edits. The ASP crosswalk maps 42 NDCs to it, sold as Doxorubicin HCl, Adriamycin by Pfizer Inc, Hikma Pharmaceuticals USA Inc., Sagent Pharmaceuticals. No current Billing and Coding Article lists J9000, so coverage follows the FDA label, compendia and any applicable NCD.

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J9000 at $3.12 per 10 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $2.71 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J9000
QuarterPayment limitPerCoinsurance
October 2026$3.1210 MG20%
July 2026$2.7110 MG—
Source: CMS Medicare Part B Drug Payment Limit File. Commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 42 NDCs from 7 labelers to J9000. Report the NDC in the claim's drug segment and bill the number of J9000 units that equals the quantity administered divided by 10 MG; the last column gives units per full package.

NDCs that crosswalk to J9000
NDCDrug nameLabelerPackage sizeBilling units / package
00069-0255-10Doxorubicin HClPfizer Inc10 × 12
00069-0277-02Doxorubicin HClPfizer Inc10 × 12
00069-0343-02Doxorubicin HClPfizer Inc25 × 15
00069-0358-20Doxorubicin HClPfizer Inc5 × 11
00069-1442-04Doxorubicin HClPfizer Inc100 × 120
00069-1542-20Doxorubicin HClPfizer Inc100 × 120
00069-3030-20Doxorubicin HClPfizer Inc5 × 11
00069-3031-20Doxorubicin HClPfizer Inc10 × 12
00069-3032-20Doxorubicin HClPfizer Inc25 × 15
00069-3034-20Doxorubicin HClPfizer Inc100 × 120
00069-3358-25Doxorubicin HClPfizer Inc25 × 15
00069-4004-05Doxorubicin HClPfizer Inc5 × 11
00069-4015-10Doxorubicin HClPfizer Inc10 × 12
00069-4026-25Doxorubicin HClPfizer Inc25 × 15
00069-4031-12Doxorubicin HClPfizer Inc10 × 12
00069-4037-01Doxorubicin HClPfizer Inc100 × 120
00069-4205-05Doxorubicin HClPfizer Inc5 × 11
00069-5629-05Doxorubicin HClPfizer Inc5 × 11
00143-9084-01Doxorubicin HClHikma Pharmaceuticals USA Inc.5 × 11
00143-9085-01Doxorubicin HClHikma Pharmaceuticals USA Inc.10 × 12
00143-9086-01Doxorubicin HClHikma Pharmaceuticals USA Inc.25 × 15
00143-9087-01Doxorubicin HClHikma Pharmaceuticals USA Inc.100 × 120
00143-9088-01Doxorubicin HClHikma Pharmaceuticals USA Inc.5 × 11
00143-9089-01Doxorubicin HClHikma Pharmaceuticals USA Inc.10 × 12
00143-9090-01Doxorubicin HClHikma Pharmaceuticals USA Inc.25 × 15
00143-9091-01Doxorubicin HClHikma Pharmaceuticals USA Inc.100 × 120
00143-9092-01Doxorubicin HClHikma Pharmaceuticals USA Inc.5 × 11
00143-9093-01Doxorubicin HClHikma Pharmaceuticals USA Inc.1 × 15
00143-9277-01AdriamycinHikma Pharmaceuticals USA Inc.1 × 15
25021-0207-05Doxorubicin HClSagent Pharmaceuticals5 × 1010
25021-0207-25Doxorubicin HClSagent Pharmaceuticals25 × 15
25021-0207-51Doxorubicin HClSagent Pharmaceuticals100 × 120
45963-0733-55Doxorubicin HClActavis Pharma, Inc.5 × 11
45963-0733-57Doxorubicin HClActavis Pharma, Inc.10 × 12
45963-0733-60Doxorubicin HClActavis Pharma, Inc.100 × 120
45963-0733-68Doxorubicin HClActavis Pharma, Inc.25 × 15
63323-0101-61Doxorubicin HClFreseniUS Kabi USA, LLC100 × 120
63323-0883-05Doxorubicin HClFreseniUS Kabi USA, LLC5 × 11
63323-0883-30Doxorubicin HClFreseniUS Kabi USA, LLC25 × 15
67457-0436-50Doxorubicin HClMylan Institutional LLC1 × 15
70860-0208-25Doxorubicin HClAthenex Pharmaceutical Division, LLC25 × 15
70860-0208-51Doxorubicin HClAthenex Pharmaceutical Division, LLC100 × 120

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J9000. For practitioners the limit is 20 units per date of service with adjudication indicator 3, a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation that the quantity was medically reasonable.

MUE values for J9000 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services203 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital203 Date of Service Edit: ClinicalClinical: Data
DME supplier203 Date of Service Edit: ClinicalClinical: Data

NCCI edits and add-on relationships

No active practitioner PTP pair lists J9000 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

J9000 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

No current Billing and Coding Article lists J9000 in its HCPCS table. Coverage then follows the drug's FDA label, compendia and any National Coverage Determination; check the Medicare Coverage Database before administering off-label.

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J9000 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J9000 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks J9000 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

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Frequently asked questions — HCPCS J9000

What does HCPCS code J9000 describe?

J9000 is defined by CMS as "Injection, doxorubicin hydrochloride, 10 mg". Each billing unit represents 10 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J9000 in October 2026?

The ASP-based payment limit is $3.12 per 10 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $2.71.

How many units of J9000 can be billed per day?

The practitioner Medically Unlikely Edit is 20 units per date of service with adjudication indicator 3 (3 Date of Service Edit: Clinical). MAI 3 edits can be appealed with documentation that the units were medically reasonable. CMS cites "Clinical: Data" as the rationale.

Which NDCs map to J9000?

The October 2026 ASP crosswalk lists 42 NDCs from 7 labelers: Doxorubicin HCl (Pfizer Inc); Doxorubicin HCl (Hikma Pharmaceuticals USA Inc.); Adriamycin (Hikma Pharmaceuticals USA Inc.); Doxorubicin HCl (Sagent Pharmaceuticals). For example NDC 00069-0255-10 is a 10 package equal to 2 billing units. The crosswalk's billing-units-per-package figure converts each package into J9000 units.

Does J9000 have NCCI bundling edits?

No active practitioner PTP pairs list J9000 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.