J9245 HCPCS code: Injection, melphalan hydrochloride, not otherwise specified, 50 mg
J9245 is the HCPCS Level II code for injection, melphalan hydrochloride, not otherwise specified, 50 mg. In 2024 Medicare paid an average of $123.09 per service for J9245 across 151 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 11 per day on outpatient hospital claims. Medicare volume rose 64% from 2022 to 2024 (92 to 151 services). In 2024, about 21 clinicians billed Medicare for J9245 for 24 beneficiaries.
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 | 1995-01-01 |
| Last action effective | 2020-07-01 |
Who bills J9245 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 21 |
| Medicare beneficiaries | 24 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9245, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 92 | 14 | $202.62 | $161.69 |
| 2023 | 97 | 13 | $189.62 | $151.08 |
| 2024 | 151 | 24 | $154.49 | $123.09 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 11 | Clinical: Society Comment |
| practitioner claims | 9 | Clinical: Society Comment |
What changed for J9245
- 1995-01-01: J9245 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 J9245?
J9245 is the HCPCS Level II code for injection, melphalan hydrochloride, not otherwise specified, 50 mg. Short descriptor: "Inj melpha hydroch nos 50 mg".
How much does Medicare pay for J9245?
In 2024, the average Medicare payment was $123.09 per service (average allowed $154.49).
Does Medicare cover J9245?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J9245 can be billed per day?
11 on outpatient hospital claims; 9 on practitioner claims (NCCI medically unlikely edits).
Related J92 codes
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Next steps
- Run a reimbursement report for a device billed under J9245
- Watch J9245 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9245
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.