J9043 HCPCS code: Injection, cabazitaxel, 1 mg
J9043 is the HCPCS Level II code for injection, cabazitaxel, 1 mg. In 2024 Medicare paid an average of $165.33 per service for J9043 across 209,437 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 60 per day on outpatient hospital claims. Medicare volume fell 31% from 2022 to 2024 (304,806 to 209,437 services). In 2024, about 1,001 clinicians billed Medicare for J9043 for 814 beneficiaries; California, Florida, Texas accounted for 34% 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 | 2012-01-01 |
| Last action effective | 2012-01-01 |
Who bills J9043 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,001 |
| Medicare beneficiaries | 814 |
| States with claims | 28 |
| Share of services in top 3 states (California, Florida, Texas) | 34% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9043, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 304,806 | 1,122 | $189.15 | $151.09 |
| 2023 | 244,301 | 941 | $198.42 | $158.10 |
| 2024 | 209,437 | 814 | $207.51 | $165.33 |
States with the most J9043 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 24,065 | $166.30 |
| Florida | 21,590 | $167.41 |
| Texas | 20,183 | $165.41 |
| Arizona | 9,055 | $165.65 |
| Virginia | 7,860 | $159.02 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 60 | Prescribing Information |
| practitioner claims | 60 | Prescribing Information |
What changed for J9043
- 2012-01-01: J9043 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 J9043?
J9043 is the HCPCS Level II code for injection, cabazitaxel, 1 mg. Short descriptor: "Cabazitaxel injection".
How much does Medicare pay for J9043?
In 2024, the average Medicare payment was $165.33 per service (average allowed $207.51).
Does Medicare cover J9043?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9043 can be billed per day?
60 on outpatient hospital claims; 60 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 J9043
- Watch J9043 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9043
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.