J9263 HCPCS code: Injection, oxaliplatin, 0.5 mg
J9263 is the HCPCS Level II code for injection, oxaliplatin, 0.5 mg. In 2024 Medicare paid an average of $0.06 per service for J9263 across 20,410,899 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 700 per day on outpatient hospital claims. Medicare volume fell 5% from 2022 to 2024 (21,517,086 to 20,410,899 services). In 2024, about 4,047 clinicians billed Medicare for J9263 for 12,164 beneficiaries; Texas, Florida, California accounted for 37% 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 | 2004-01-01 |
| Last action effective | 2018-01-01 |
Who bills J9263 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 4,047 |
| Medicare beneficiaries | 12,164 |
| States with claims | 49 |
| Share of services in top 3 states (Texas, Florida, California) | 37% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9263, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 21,517,086 | 12,846 | $0.06 | $0.05 |
| 2023 | 20,971,094 | 12,455 | $0.07 | $0.06 |
| 2024 | 20,410,899 | 12,164 | $0.07 | $0.06 |
States with the most J9263 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 2,603,554 | $0.06 |
| Florida | 2,498,879 | $0.06 |
| California | 2,406,968 | $0.06 |
| Illinois | 1,021,781 | $0.06 |
| Virginia | 905,276 | $0.06 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 700 | Clinical: Data |
| practitioner claims | 700 | Clinical: Data |
What changed for J9263
- 2004-01-01: J9263 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 J9263?
J9263 is the HCPCS Level II code for injection, oxaliplatin, 0.5 mg. Short descriptor: "Oxaliplatin".
How much does Medicare pay for J9263?
In 2024, the average Medicare payment was $0.06 per service (average allowed $0.07).
Does Medicare cover J9263?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9263 can be billed per day?
700 on outpatient hospital claims; 700 on practitioner claims (NCCI medically unlikely edits).
Related J92 codes
- J9200 — Injection, floxuridine, 500 mg
- 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
- J9208 — Injection, ifosfamide, 1 gram
- J9209 — Injection, mesna, 200 mg
- J9210 — Injection, emapalumab-lzsg, 1 mg
- J9211 — Injection, idarubicin hydrochloride, 5 mg
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Next steps
- Run a reimbursement report for a device billed under J9263
- Watch J9263 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9263
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.