J9280 HCPCS code: Injection, mitomycin, 5 mg
J9280 is the HCPCS Level II code for injection, mitomycin, 5 mg. In 2024 Medicare paid an average of $43.62 per service for J9280 across 43,994 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 12 per day on outpatient hospital claims. Medicare volume fell 25% from 2022 to 2024 (58,377 to 43,994 services). In 2024, about 1,602 clinicians billed Medicare for J9280 for 3,016 beneficiaries; Florida, New Jersey, Pennsylvania accounted for 32% 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 | 1986-01-01 |
| Last action effective | 2013-01-01 |
Who bills J9280 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,602 |
| Medicare beneficiaries | 3,016 |
| States with claims | 38 |
| Share of services in top 3 states (Florida, New Jersey, Pennsylvania) | 32% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9280, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 58,377 | 3,729 | $48.78 | $38.57 |
| 2023 | 48,445 | 3,366 | $55.33 | $43.74 |
| 2024 | 43,994 | 3,016 | $55.20 | $43.62 |
States with the most J9280 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 8,030 | $43.97 |
| New Jersey | 2,828 | $44.07 |
| Pennsylvania | 2,759 | $43.65 |
| California | 2,625 | $43.76 |
| New York | 2,364 | $39.24 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 12 | Prescribing Information |
| practitioner claims | 12 | Prescribing Information |
What changed for J9280
- 1986-01-01: J9280 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 J9280?
J9280 is the HCPCS Level II code for injection, mitomycin, 5 mg. Short descriptor: "Mitomycin injection".
How much does Medicare pay for J9280?
In 2024, the average Medicare payment was $43.62 per service (average allowed $55.20).
Does Medicare cover J9280?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J9280 can be billed per day?
12 on outpatient hospital claims; 12 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
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J9280
- Watch J9280 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9280
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.