J9028 HCPCS code: Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram

J9028 is the HCPCS Level II code for injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 400 per day on outpatient hospital claims.

Code details

FieldValue
SectionJ codes — Drugs administered other than oral method
Coverage codeC — Carrier judgment
Pricing indicator51 — Drug or biological (priced per ASP/average sales price rules)
BETOS categoryO1D — Chemotherapy
Added2025-01-01
Last action effective2025-01-01

NCCI unit limits (MUE)

Claim typeMax units per dayRationale
outpatient hospital claims400CMS Policy
practitioner claims400CMS Policy

What changed for J9028

Frequently asked questions

What is HCPCS code J9028?

J9028 is the HCPCS Level II code for injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram. Short descriptor: "Inj, nogapendekin pmln, 1mcg".

Does Medicare cover J9028?

Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.

How many units of J9028 can be billed per day?

400 on outpatient hospital claims; 400 on practitioner claims (NCCI medically unlikely edits).

Related J90 codes

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Next steps

Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.

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