J9075 HCPCS code: Injection, cyclophosphamide, not otherwise specified, 5 mg
J9075 is the HCPCS Level II code for injection, cyclophosphamide, not otherwise specified, 5 mg. In 2024 Medicare paid an average of $0.79 per service for J9075 across 1,928,499 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 1500 per day on DME suppliers. In 2024, about 1,435 clinicians billed Medicare for J9075 for 2,335 beneficiaries; California, Maryland, Texas accounted for 32% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1D — Chemotherapy |
| Added | 2024-04-01 |
| Last action effective | 2024-04-01 |
Who bills J9075 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,435 |
| Medicare beneficiaries | 2,335 |
| States with claims | 31 |
| Share of services in top 3 states (California, Maryland, Texas) | 32% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9075, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 1,928,499 | 2,335 | $0.99 | $0.79 |
States with the most J9075 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 324,621 | $0.79 |
| Maryland | 149,530 | $0.78 |
| Texas | 123,775 | $0.79 |
| Arizona | 122,156 | $0.79 |
| Florida | 106,092 | $0.78 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1500 | Prescribing Information |
| outpatient hospital claims | 1500 | Prescribing Information |
| practitioner claims | 1500 | Prescribing Information |
What changed for J9075
- 2024-04-01: J9075 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 J9075?
J9075 is the HCPCS Level II code for injection, cyclophosphamide, not otherwise specified, 5 mg. Short descriptor: "Inj, cyclophosphamide, nos".
How much does Medicare pay for J9075?
In 2024, the average Medicare payment was $0.79 per service (average allowed $0.99).
Does Medicare cover J9075?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J9075 can be billed per day?
1500 on DME suppliers; 1500 on outpatient hospital claims; 1500 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 J9075
- Watch J9075 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9075
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.