J9267 HCPCS code: Injection, paclitaxel, 1 mg
J9267 is the HCPCS Level II code for injection, paclitaxel, 1 mg. In 2024 Medicare paid an average of $0.08 per service for J9267 across 14,288,872 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 750 per day on outpatient hospital claims. Medicare volume fell 13% from 2022 to 2024 (16,351,982 to 14,288,872 services). In 2024, about 4,518 clinicians billed Medicare for J9267 for 15,445 beneficiaries; Texas, Florida, California accounted for 35% 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 | 2015-01-01 |
| Last action effective | 2015-01-01 |
Who bills J9267 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 4,518 |
| Medicare beneficiaries | 15,445 |
| States with claims | 50 |
| Share of services in top 3 states (Texas, Florida, California) | 35% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9267, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 16,351,982 | 17,493 | $0.12 | $0.10 |
| 2023 | 15,037,291 | 16,433 | $0.13 | $0.10 |
| 2024 | 14,288,872 | 15,445 | $0.10 | $0.08 |
States with the most J9267 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 1,900,821 | $0.08 |
| Florida | 1,733,999 | $0.08 |
| California | 1,413,954 | $0.08 |
| Illinois | 751,756 | $0.08 |
| Arizona | 672,463 | $0.08 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 750 | Prescribing Information |
| practitioner claims | 750 | Prescribing Information |
Medicare policy articles for this code
- A52450: Billing and Coding: Paclitaxel (e.g., Taxol®/Abraxane ™) (Wellpoint Federal (MAC - Part A, MAC - Part B))
Covered diagnoses (699 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C00.0 | Malignant neoplasm of external upper lip | 1 |
| C00.1 | Malignant neoplasm of external lower lip | 1 |
| C00.2 | Malignant neoplasm of external lip, unspecified | 1 |
| C00.3 | Malignant neoplasm of upper lip, inner aspect | 1 |
| C00.4 | Malignant neoplasm of lower lip, inner aspect | 1 |
| C00.5 | Malignant neoplasm of lip, unspecified, inner aspect | 1 |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified | 1 |
| C00.8 | Malignant neoplasm of overlapping sites of lip | 1 |
| C00.9 | Malignant neoplasm of lip, unspecified | 1 |
| C01 | Malignant neoplasm of base of tongue | 1 |
Showing 10 of 699. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J9267
- 2015-01-01: J9267 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 J9267?
J9267 is the HCPCS Level II code for injection, paclitaxel, 1 mg. Short descriptor: "Paclitaxel injection".
How much does Medicare pay for J9267?
In 2024, the average Medicare payment was $0.08 per service (average allowed $0.10).
Does Medicare cover J9267?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J9267?
Medicare policy articles that cite J9267 list 699 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C00.0 (Malignant neoplasm of external upper lip), C00.1 (Malignant neoplasm of external lower lip), C00.2 (Malignant neoplasm of external lip, unspecified). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J9267 can be billed per day?
750 on outpatient hospital claims; 750 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 J9267
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Sources: CMS HCPCS Level II release October 2026; 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.