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HCPCS J9041 · Level II · Part B drug

HCPCS J9041: Injection, bortezomib, 0.1 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 J9041

Billing unit
0.1 MG
Injection, bortezomib, 0.1mg
ASP payment limit
$2.628
October 2026; +29.0% vs July 2026
Practitioner MUE
35
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J9041 is the Level II code for Injection, bortezomib, 0.1 mg, billed per 0.1 MG. The Medicare Part B ASP payment limit for October 2026 is $2.628 per billing unit, up 29.0% from July 2026. The practitioner MUE allows up to 35 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 20 NDCs to it, sold as Bortezomib, Velcade by Hikma Pharmaceuticals USA Inc., Pfizer Inc, Baxter Healthcare Corporation. No current Billing and Coding Article lists J9041, 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 J9041 at $2.628 per 0.1 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $2.037 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J9041
QuarterPayment limitPerCoinsurance
October 2026$2.6280.1 MG20%
July 2026$2.0370.1 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 20 NDCs from 17 labelers to J9041. Report the NDC in the claim's drug segment and bill the number of J9041 units that equals the quantity administered divided by 0.1 MG; the last column gives units per full package.

NDCs that crosswalk to J9041
NDCDrug nameLabelerPackage sizeBilling units / package
00143-9098-01BortezomibHikma Pharmaceuticals USA Inc.1 × 135
00409-1700-01BortezomibPfizer Inc1 × 135
10019-0991-01BortezomibBaxter Healthcare Corporation1 × 135
25021-0244-10BortezomibSagent Pharmaceuticals1 × 135
25021-0262-10BortezomibSagent Pharmaceuticals1 × 135
43598-0426-60BortezomibDr. Reddy's Laboratories Inc.1 × 135
50742-0484-01BortezomibIngenus Pharmaceuticals LLC1 × 135
55150-0337-01BortezomibEugia US LLC1 × 135
60505-6050-04BortezomibApotex Corp1 × 135
63020-0049-01VelcadeTakeda Pharmaceuticals America, Inc.1 × 135
63323-0821-10BortezomibFreseniUS Kabi USA, LLC1 × 135
68001-0534-36BortezomibBluePoint Laboratories1 × 135
68001-0540-36BortezomibBluePoint Laboratories1 × 135
68001-0541-36BortezomibBluePoint Laboratories1 × 135
70069-0836-01BortezomibSomerset Pharma, LLC1 × 135
70710-1411-01BortezomibZydus Pharmaceuticals (USA) Inc.1 × 135
70860-0225-10BortezomibAthenex Pharmaceutical Division, LLC1 × 135
71288-0118-10BortezomibMeitheal Pharmaceuticals Inc.1 × 135
72205-0183-01BortezomibNovadoz Pharmaceuticals LLC1 × 135
72603-0270-01BortezomibNorthstar RxLLC1 × 135

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J9041. For practitioners the limit is 35 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 J9041 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services353 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital353 Date of Service Edit: ClinicalClinical: Data
DME supplier353 Date of Service Edit: ClinicalPrescribing Information

NCCI edits and add-on relationships

No active practitioner PTP pair lists J9041 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.

J9041 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 J9041 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, J9041 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J9041 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 J9041 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.

Explore QuickCodeExplore QuickRCMBook a demo

Frequently asked questions — HCPCS J9041

What does HCPCS code J9041 describe?

J9041 is defined by CMS as "Injection, bortezomib, 0.1 mg". Each billing unit represents 0.1 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J9041 in October 2026?

The ASP-based payment limit is $2.628 per 0.1 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $2.037.

How many units of J9041 can be billed per day?

The practitioner Medically Unlikely Edit is 35 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 J9041?

The October 2026 ASP crosswalk lists 20 NDCs from 17 labelers: Bortezomib (Hikma Pharmaceuticals USA Inc.); Bortezomib (Pfizer Inc); Bortezomib (Baxter Healthcare Corporation); Bortezomib (Sagent Pharmaceuticals). For example NDC 00143-9098-01 is a 1 package equal to 35 billing units. The crosswalk's billing-units-per-package figure converts each package into J9041 units.

Does J9041 have NCCI bundling edits?

No active practitioner PTP pairs list J9041 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.