J9036 HCPCS code: Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg
J9036 is the HCPCS Level II code for injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg. In 2024 Medicare paid an average of $8.56 per service for J9036 across 151,590 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 360 per day on outpatient hospital claims. Medicare volume fell 65% from 2022 to 2024 (437,556 to 151,590 services). In 2024, about 224 clinicians billed Medicare for J9036 for 204 beneficiaries; New York, Mississippi, Michigan accounted for 47% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1D — Chemotherapy |
| Added | 2019-07-01 |
| Last action effective | 2019-07-01 |
Who bills J9036 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 224 |
| Medicare beneficiaries | 204 |
| States with claims | 8 |
| Share of services in top 3 states (New York, Mississippi, Michigan) | 47% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9036, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 437,556 | 450 | $19.43 | $15.51 |
| 2023 | 325,700 | 370 | $16.26 | $12.95 |
| 2024 | 151,590 | 204 | $10.75 | $8.56 |
States with the most J9036 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 21,569 | $6.69 |
| Mississippi | 17,360 | $6.74 |
| Michigan | 16,851 | $9.78 |
| Illinois | 16,623 | $8.08 |
| North Carolina | 13,604 | $9.09 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 360 | Prescribing Information |
| practitioner claims | 360 | Prescribing Information |
What changed for J9036
- 2019-07-01: J9036 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J9036?
J9036 is the HCPCS Level II code for injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg. Short descriptor: "Inj. belrapzo/bendamustine".
How much does Medicare pay for J9036?
In 2024, the average Medicare payment was $8.56 per service (average allowed $10.75).
Does Medicare cover J9036?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9036 can be billed per day?
360 on outpatient hospital claims; 360 on practitioner claims (NCCI medically unlikely edits).
Related J90 codes
- J9000 — Injection, doxorubicin hydrochloride, 10 mg
- J9010 — Injection, alemtuzumab, 10 mg
- J9011 — Injection, datopotamab deruxtecan-dlnk, 1 mg
- J9015 — Injection, aldesleukin, per single use vial
- J9017 — Injection, arsenic trioxide, 1 mg
- J9019 — Injection, asparaginase (erwinaze), 1,000 iu
- J9020 — Injection, asparaginase, not otherwise specified, 10,000 units
- J9021 — Injection, asparaginase, recombinant, (rylaze), 0.1 mg
- J9022 — Injection, atezolizumab, 10 mg
- J9023 — Injection, avelumab, 10 mg
- J9024 — Injection, atezolizumab, 5 mg and hyaluronidase-tqjs
- J9025 — Injection, azacitidine, 1 mg
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J9036
- Watch J9036 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9036
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.