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HCPCS J9267 · Level II · Part B drug

HCPCS J9267: Injection, paclitaxel, 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 J9267

Billing unit
1 MG
Paclitaxel injection
ASP payment limit
$0.108
October 2026; -3.6% vs July 2026
Practitioner MUE
750
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
1
5 states

TL;DR

HCPCS J9267 is the Level II code for Injection, paclitaxel, 1 mg, billed per 1 MG. The Medicare Part B ASP payment limit for October 2026 is $0.108 per billing unit, down 3.6% from July 2026. The practitioner MUE allows up to 750 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 32 NDCs to it, sold as Paclitaxel by Teva Parenteral Medicines, Inc., Northstar RxLLC, Heritage Pharmaceuticals Inc.. 1 Medicare coverage article lists the code across 5 states, including .

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J9267 at $0.108 per 1 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.112 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J9267
QuarterPayment limitPerCoinsurance
October 2026$0.1081 MG20%
July 2026$0.1121 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 32 NDCs from 11 labelers to J9267. Report the NDC in the claim's drug segment and bill the number of J9267 units that equals the quantity administered divided by 1 MG; the last column gives units per full package.

NDCs that crosswalk to J9267
NDCDrug nameLabelerPackage sizeBilling units / package
00703-3213-01PaclitaxelTeva Parenteral Medicines, Inc.5 × 130
00703-3213-81PaclitaxelTeva Parenteral Medicines, Inc.5 × 130
00703-3216-01PaclitaxelTeva Parenteral Medicines, Inc.16.7 × 1100
00703-3216-81PaclitaxelTeva Parenteral Medicines, Inc.16.7 × 1100
00703-3217-01PaclitaxelTeva Parenteral Medicines, Inc.25 × 1150
00703-3218-01PaclitaxelTeva Parenteral Medicines, Inc.50 × 1300
00703-3218-81PaclitaxelTeva Parenteral Medicines, Inc.50 × 1300
16714-0137-01PaclitaxelNorthstar RxLLC50 × 1300
23155-0882-31PaclitaxelHeritage Pharmaceuticals Inc.5 × 130
23155-0883-31PaclitaxelHeritage Pharmaceuticals Inc.16.7 × 1100
23155-0884-31PaclitaxelHeritage Pharmaceuticals Inc.50 × 1300
25021-0255-05PaclitaxelSagent Pharmaceuticals5 × 130
25021-0255-17PaclitaxelSagent Pharmaceuticals16.7 × 1100
25021-0255-50PaclitaxelSagent Pharmaceuticals50 × 1300
61703-0015-04PaclitaxelPfizer Inc5 × 130
61703-0342-09PaclitaxelPfizer Inc5 × 130
61703-0342-22PaclitaxelPfizer Inc16.7 × 1100
61703-0342-50PaclitaxelPfizer Inc50 × 1300
62332-0620-05PaclitaxelAlembic Pharmaceuticals Inc.5 × 130
62332-0621-17PaclitaxelAlembic Pharmaceuticals Inc.16.7 × 1100
62332-0622-50PaclitaxelAlembic Pharmaceuticals Inc.50 × 1300
63323-0763-16PaclitaxelFreseniUS Kabi USA, LLC16.7 × 1100
63323-0763-50PaclitaxelFreseniUS Kabi USA, LLC50 × 1300
68001-0516-27PaclitaxelBluePoint Laboratories50 × 1300
68001-0705-27PaclitaxelBluepoint Laboratories50 × 1300
70860-0200-05PaclitaxelAthenex Pharmaceutical Division, LLC5 × 130
70860-0200-17PaclitaxelAthenex Pharmaceutical Division, LLC16.7 × 1100
70860-0200-50PaclitaxelAthenex Pharmaceutical Division, LLC50 × 1300
70860-0215-66PaclitaxelAthenex Pharmaceutical Division, LLC5 × 130
70860-0215-67PaclitaxelAthenex Pharmaceutical Division, LLC16.7 × 1100
70860-0215-68PaclitaxelAthenex Pharmaceutical Division, LLC50 × 1300
72205-0063-01PaclitaxelNovadoz Pharmaceuticals LLC50 × 1300

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J9267. For practitioners the limit is 750 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 J9267 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services7503 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital7503 Date of Service Edit: ClinicalPrescribing Information
DME supplier03 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J9267 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.

J9267 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

1 current Medicare Administrative Contractor article lists J9267 in their HCPCS tables, covering 5 states. Each article carries the covered and non-covered ICD-10 codes that medical-necessity denials (CARC 50) are adjudicated against.

Billing and Coding Articles listing J9267
ArticleTitleContractor(s)StatesRelated LCD
Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)Wellpoint FederalCT IL MN NY WIL33394

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J9267 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J9267 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 J9267 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 J9267

What does HCPCS code J9267 describe?

J9267 is defined by CMS as "Injection, paclitaxel, 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 J9267 in October 2026?

The ASP-based payment limit is $0.108 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 $0.112.

How many units of J9267 can be billed per day?

The practitioner Medically Unlikely Edit is 750 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 "Prescribing Information" as the rationale.

Which NDCs map to J9267?

The October 2026 ASP crosswalk lists 32 NDCs from 11 labelers: Paclitaxel (Teva Parenteral Medicines, Inc.); Paclitaxel (Northstar RxLLC); Paclitaxel (Heritage Pharmaceuticals Inc.); Paclitaxel (Sagent Pharmaceuticals). For example NDC 00703-3213-01 is a 5 package equal to 30 billing units. The crosswalk's billing-units-per-package figure converts each package into J9267 units.

Does J9267 have NCCI bundling edits?

No active practitioner PTP pairs list J9267 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Which Medicare coverage articles mention J9267?

1 current Billing and Coding Article in the Medicare Coverage Database list J9267, covering 5 states: (Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™)).

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.