J9293 HCPCS code: Injection, mitoxantrone hydrochloride, per 5 mg
J9293 is the HCPCS Level II code for injection, mitoxantrone hydrochloride, per 5 mg. In 2024 Medicare paid an average of $36.44 per service for J9293 across 441 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 8 per day on outpatient hospital claims. Medicare volume fell 70% from 2022 to 2024 (1,475 to 441 services). In 2024, about 47 clinicians billed Medicare for J9293 for 32 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 | 1990-01-01 |
| Last action effective | 1997-01-01 |
Who bills J9293 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 47 |
| Medicare beneficiaries | 32 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9293, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,475 | 86 | $34.00 | $26.95 |
| 2023 | 707 | 39 | $44.12 | $35.01 |
| 2024 | 441 | 32 | $46.38 | $36.44 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 8 | Clinical: Data |
| practitioner claims | 8 | Clinical: Data |
What changed for J9293
- 1990-01-01: J9293 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 J9293?
J9293 is the HCPCS Level II code for injection, mitoxantrone hydrochloride, per 5 mg. Short descriptor: "Mitoxantrone hydrochl / 5 mg".
How much does Medicare pay for J9293?
In 2024, the average Medicare payment was $36.44 per service (average allowed $46.38).
Does Medicare cover J9293?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J9293 can be billed per day?
8 on outpatient hospital claims; 8 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 J9293
- Watch J9293 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9293
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.