J9039 HCPCS code: Injection, blinatumomab, 1 microgram
J9039 is the HCPCS Level II code for injection, blinatumomab, 1 microgram. In 2024 Medicare paid an average of $116.23 per service for J9039 across 51,142 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 280 per day on DME suppliers. Medicare volume rose 226% from 2022 to 2024 (15,708 to 51,142 services). In 2024, 54 suppliers billed Medicare for J9039 (purchases), serving 97 beneficiaries; Pennsylvania, California, Maryland accounted for 36% 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 | 2016-01-01 |
| Last action effective | 2016-01-01 |
Who bills J9039 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 54 |
| Referring clinicians | 104 |
| Medicare beneficiaries | 97 |
| States with claims | 20 |
| Share of services in top 3 states (Pennsylvania, California, Maryland) | 36% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 46 | 74 |
| 2023 | 48 | 104 |
| 2024 | 54 | 97 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9039, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 15,708 | 18 | $126.72 | $101.08 |
| 2023 | 44,224 | 31 | $123.87 | $99.02 |
| 2024 | 51,142 | 30 | $144.94 | $116.23 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 280 | Clinical: Data |
| outpatient hospital claims | 210 | Prescribing Information |
| practitioner claims | 210 | Prescribing Information |
Medicare policy articles for this code
- A52507: External Infusion Pumps - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
Covered diagnoses (460 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C91.00 | Acute lymphoblastic leukemia not having achieved remission | 1 |
| C91.01 | Acute lymphoblastic leukemia, in remission | 1 |
| C91.02 | Acute lymphoblastic leukemia, in relapse | 1 |
| D80.0 | Hereditary hypogammaglobulinemia | 1 |
| D80.2 | Selective deficiency of immunoglobulin A [IgA] | 1 |
| D80.3 | Selective deficiency of immunoglobulin G [IgG] subclasses | 1 |
| D80.4 | Selective deficiency of immunoglobulin M [IgM] | 1 |
| D80.5 | Immunodeficiency with increased immunoglobulin M [IgM] | 1 |
| D80.6 | Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia | 1 |
| D80.7 | Transient hypogammaglobulinemia of infancy | 1 |
Showing 10 of 460. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J9039
- 2016-01-01: J9039 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 J9039?
J9039 is the HCPCS Level II code for injection, blinatumomab, 1 microgram. Short descriptor: "Injection, blinatumomab".
How much does Medicare pay for J9039?
In 2024, the average Medicare payment was $116.23 per service (average allowed $144.94).
Does Medicare cover J9039?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J9039?
Medicare policy articles that cite J9039 list 460 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C91.00 (Acute lymphoblastic leukemia not having achieved remission), C91.01 (Acute lymphoblastic leukemia, in remission), C91.02 (Acute lymphoblastic leukemia, in relapse). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J9039 can be billed per day?
280 on DME suppliers; 210 on outpatient hospital claims; 210 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 J9039
- Watch J9039 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9039
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.