J9223 HCPCS code: Injection, lurbinectedin, 0.1 mg
J9223 is the HCPCS Level II code for injection, lurbinectedin, 0.1 mg. In 2024 Medicare paid an average of $156.63 per service for J9223 across 193,969 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 120 per day on outpatient hospital claims. Medicare volume rose 2% from 2022 to 2024 (190,809 to 193,969 services). In 2024, about 845 clinicians billed Medicare for J9223 for 650 beneficiaries; Florida, Illinois, Tennessee accounted for 30% 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 | 2021-01-01 |
| Last action effective | 2021-01-01 |
Who bills J9223 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 845 |
| Medicare beneficiaries | 650 |
| States with claims | 21 |
| Share of services in top 3 states (Florida, Illinois, Tennessee) | 30% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9223, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 190,809 | 703 | $179.27 | $143.13 |
| 2023 | 195,511 | 684 | $186.93 | $148.94 |
| 2024 | 193,969 | 650 | $196.60 | $156.63 |
States with the most J9223 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 23,303 | $157.39 |
| Illinois | 13,463 | $157.54 |
| Tennessee | 12,640 | $151.22 |
| Texas | 11,449 | $155.21 |
| New York | 11,240 | $157.78 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 120 | CMS Policy |
| practitioner claims | 120 | CMS Policy |
What changed for J9223
- 2021-01-01: J9223 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 J9223?
J9223 is the HCPCS Level II code for injection, lurbinectedin, 0.1 mg. Short descriptor: "Inj. lurbinectedin, 0.1 mg".
How much does Medicare pay for J9223?
In 2024, the average Medicare payment was $156.63 per service (average allowed $196.60).
Does Medicare cover J9223?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9223 can be billed per day?
120 on outpatient hospital claims; 120 on practitioner claims (NCCI medically unlikely edits).
Related J92 codes
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- J9201 — Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg
- J9202 — Goserelin acetate implant, per 3.6 mg
- J9203 — Injection, gemtuzumab ozogamicin, 0.1 mg
- J9204 — Injection, mogamulizumab-kpkc, 1 mg
- J9205 — Injection, irinotecan liposome, 1 mg
- J9206 — Injection, irinotecan, 20 mg
- J9207 — Injection, ixabepilone, 1 mg
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- J9210 — Injection, emapalumab-lzsg, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J9223
- Watch J9223 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9223
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.