J9172 HCPCS code: Injection, docetaxel (docivyx), 1 mg
J9172 is the HCPCS Level II code for injection, docetaxel (docivyx), 1 mg. In 2024 Medicare paid an average of $42.37 per service for J9172 across 223,438 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 300 per day on DME suppliers. In 2024, about 411 clinicians billed Medicare for J9172 for 576 beneficiaries; Tennessee, California, Texas accounted for 40% 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 | 2024-01-01 |
| Last action effective | 2024-10-01 |
Who bills J9172 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 411 |
| Medicare beneficiaries | 576 |
| States with claims | 18 |
| Share of services in top 3 states (Tennessee, California, Texas) | 40% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9172, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 223,438 | 576 | $53.17 | $42.37 |
States with the most J9172 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Tennessee | 40,480 | $39.40 |
| California | 23,042 | $64.23 |
| Texas | 20,113 | $39.97 |
| Maryland | 17,477 | $39.97 |
| New Jersey | 15,446 | $39.97 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 300 | Prescribing Information |
| outpatient hospital claims | 300 | Prescribing Information |
| practitioner claims | 300 | Prescribing Information |
What changed for J9172
- 2024-01-01: J9172 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 J9172?
J9172 is the HCPCS Level II code for injection, docetaxel (docivyx), 1 mg. Short descriptor: "Docetaxel (docivyx), 1 mg".
How much does Medicare pay for J9172?
In 2024, the average Medicare payment was $42.37 per service (average allowed $53.17).
Does Medicare cover J9172?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9172 can be billed per day?
300 on DME suppliers; 300 on outpatient hospital claims; 300 on practitioner claims (NCCI medically unlikely edits).
Related J91 codes
- J9100 — Injection, cytarabine, 100 mg
- J9118 — Injection, calaspargase pegol-mknl, 10 units
- J9119 — Injection, cemiplimab-rwlc, 1 mg
- J9120 — Injection, dactinomycin, 0.5 mg
- J9130 — Dacarbazine, 100 mg
- J9144 — Injection, daratumumab, 10 mg and hyaluronidase-fihj
- J9145 — Injection, daratumumab, 10 mg
- J9150 — Injection, daunorubicin, 10 mg
- J9151 — Injection, daunorubicin citrate, liposomal formulation, 10 mg
- J9153 — Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
- J9155 — Injection, degarelix, 1 mg
- J9160 — Injection, denileukin diftitox, 300 micrograms
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Next steps
- Run a reimbursement report for a device billed under J9172
- Watch J9172 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9172
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.