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HCPCS J9017 · Level II · Part B drug

HCPCS J9017: Injection, arsenic trioxide, 1 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 J9017

Billing unit
1 MG
Arsenic trioxide injection
ASP payment limit
$3.837
October 2026; -24.3% vs July 2026
Practitioner MUE
30
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J9017 is the Level II code for Injection, arsenic trioxide, 1 mg, billed per 1 MG. The Medicare Part B ASP payment limit for October 2026 is $3.837 per billing unit, down 24.3% from July 2026. The practitioner MUE allows up to 30 units per date of service (MAI 3). Under OPPS it carries status indicator N. With a 1 mg billing unit, a single administration can be hundreds of units; the unit count on the claim must equal the milligrams given, and rounding rules for partial units follow the contractor's guidance. The ASP crosswalk maps 22 NDCs to it, sold as Arsenic Trioxide, Trisenox by Sandoz Inc., Nexus Pharmaceuticals, LLC, Heritage Pharmaceuticals Inc.. No current Billing and Coding Article lists J9017, 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 J9017 at $3.837 per 1 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $5.069 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J9017
QuarterPayment limitPerCoinsurance
October 2026$3.8371 MG20%
July 2026$5.0691 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 22 NDCs from 13 labelers to J9017. Report the NDC in the claim's drug segment and bill the number of J9017 units that equals the quantity administered divided by 1 MG; the last column gives units per full package.

NDCs that crosswalk to J9017
NDCDrug nameLabelerPackage sizeBilling units / package
00781-3498-94Arsenic TrioxideSandoz Inc.6 × 112
00781-3498-95Arsenic TrioxideSandoz Inc.6 × 10120
14789-0600-10Arsenic TrioxideNexus Pharmaceuticals, LLC10 × 10100
23155-0869-41Arsenic TrioxideHeritage Pharmaceuticals Inc.10 × 10100
23155-0870-41Arsenic TrioxideHeritage Pharmaceuticals Inc.6 × 10120
25021-0226-10Arsenic TrioxideSagent Pharmaceuticals10 × 10100
25021-0227-06Arsenic TrioxideSagent Pharmaceuticals6 × 10120
50742-0438-10Arsenic TrioxideIngenus Pharmaceuticals LLC10 × 110
63323-0637-10Arsenic TrioxideFreseniUS Kabi USA, LLC10 × 10100
63459-0601-06TrisenoxCephalon, LLC6 × 10120
68382-0997-10Arsenic TrioxideZydus Pharmaceuticals (USA) Inc.10 × 10100
69918-0720-02Arsenic TrioxideNordic Pharma, Inc10 × 220
69918-0720-10Arsenic TrioxideNordic Pharma, Inc10 × 10100
70121-1483-07Arsenic TrioxideAmneal Pharmaceuticals, LLC10 × 10100
70121-1658-01Arsenic TrioxideAmneal Pharmaceuticals, LLC6 × 10120
70710-1610-06Arsenic TrioxideZydus Pharmaceuticals (USA) Inc.6 × 10120
70710-1895-06Arsenic TrioxideZydus Pharmaceuticals (USA) Inc.10 × 10100
70710-1896-06Arsenic TrioxideZydus Pharmaceuticals (USA) Inc.6 × 10120
70860-0217-10Arsenic TrioxideAthenex Pharmaceutical Division, LLC10 × 110
72205-0171-07Arsenic TrioxideNovadoz Pharmaceuticals LLC10 × 10100
72205-0172-07Arsenic TrioxideNovadoz Pharmaceuticals LLC6 × 10120
72603-0339-10Arsenic TrioxideNorthstar RxLLC10 × 10100

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J9017. For practitioners the limit is 30 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 J9017 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services303 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital303 Date of Service Edit: ClinicalClinical: Data
DME supplier03 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J9017 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.

J9017 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 J9017 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, J9017 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J9017 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 J9017 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 J9017

What does HCPCS code J9017 describe?

J9017 is defined by CMS as "Injection, arsenic trioxide, 1 mg". Each billing unit represents 1 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J9017 in October 2026?

The ASP-based payment limit is $3.837 per 1 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $5.069.

How many units of J9017 can be billed per day?

The practitioner Medically Unlikely Edit is 30 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 J9017?

The October 2026 ASP crosswalk lists 22 NDCs from 13 labelers: Arsenic Trioxide (Sandoz Inc.); Arsenic Trioxide (Nexus Pharmaceuticals, LLC); Arsenic Trioxide (Heritage Pharmaceuticals Inc.); Arsenic Trioxide (Sagent Pharmaceuticals). For example NDC 00781-3498-94 is a 6 package equal to 12 billing units. The crosswalk's billing-units-per-package figure converts each package into J9017 units.

Does J9017 have NCCI bundling edits?

No active practitioner PTP pairs list J9017 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.