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    HCPCS Details

    HCPC J9395
    Short Description Injection, fulvestrant
    Long Description Injection, fulvestrant, 25 mg
    Pricing indicator 51
    Coverage code C
    ASC payment group code YY
    BETOS2 code O1E
    Action code N
    Type of service 1
    Effective date 2004-01-01
    Date Added 2004-01-01

    HCPCS/NDC Cross-Walk

    NDC HCPC Description Drug Name Labeler Name HCPCS Dosage PKG Size PKG QTY Bill Units Bill Units PKG
    00143902202 J9395 Injection, fulvestrant Fulvestrant Hikma Pharmaceuticals USA Inc. 25 mg 5 2 10 20
    00310072010 J9395 Injection, fulvestrant Faslodex ASTRAZENECA 25 MG 5 2 10 20
    00781307912 J9395 Injection, fulvestrant FULVESTRANT SANDOZ 25 MG 5 2 10 20
    00781349212 J9395 Injection, fulvestrant FULVESTRANT SANDOZ 25 MG 5 2 10 20
    00781905512 J9395 Injection, fulvestrant Fulvestrant SANDOZ 25 MG 5 2 10 20
    16714007002 J9395 Injection, fulvestrant FULVESTRANT NORTHSTAR RX LLC 25 MG 5 2 10 20
    16729043630 J9395 Injection, fulvestrant Fulvestrant ACCORD HEALTHCARE INC. 25 MG 5 2 10 20
    25021046274 J9395 Injection, fulvestrant FULVESTRANT SAGENT PHARMACEUTICALS INC 25 MG 5 2 10 20
    43598026202 J9395 Injection, fulvestrant FULVESTRANT DR. REDDY'S LABORATORIES, INC. 25 MG 5 2 10 20
    67457031105 J9395 Injection, fulvestrant FULVESTRANT MYLAN INSTITUTIONAL INC. 25 MG 5 2 10 20
    68001042485 J9395 Injection, fulvestrant FULVESTRANT AMERICAN HEALTH PACKAGING 25 MG 5 2 10 20
    68001048485 J9395 Injection, fulvestrant Fulvestrant Bluepoint Laboratories 25 MG 5 2 10 20
    68462031732 J9395 Injection, fulvestrant Fulvestrant GLENMARK PHARMACEUTICALS INC., USA 25 MG 5 2 10 20
    70121146302 J9395 Injection, fulvestrant Fulvestrant AMNEAL BIOSCIENCES 25 MG 5 2 10 20
    70710168808 J9395 Injection, fulvestrant Fulvestrant ZYDUS PHARMACEUTICALS (USA) INC. 25 MG 5 2 10 20
    70860021174 J9395 Injection, fulvestrant Fulvestrant ATHENEX 25 MG 5 2 10 20
    71288055586 J9395 Injection, fulvestrant Fulvestrant MEITHEAL PHARMACEUTICALS 25 MG 5 2 10 20
    72603010502 J9395 Injection, fulvestrant Fulvestrant NORTHSTAR RX LLC 25 MG 5 2 10 20
    The ASP crosswalks are maintained by the Division of Data Analysis and Market Based Pricing to support ASP-based Medicare Part B payments only. The crosswalks are intended to help the public (including entities that submit manufacturer ASP data and providers who bill for drugs) understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes. The crosswalks are not intended to be a comprehensive list of all drugs/NDCs available in the United States. The NDC to HCPCS Crosswalk also includes information on the NDC package size and the number of billable units (as defined by the HCPCS code descriptor). Comments on the file may be sent to [email protected].

    HCPCS Billing Calculator

    Dosage given to patient (per dose)
    HCPCS Dosage 25 MG
    HCPCS/CPT Billing Units 0.04
    Total doses ordered
    Billing Units 0.04

    Drug Details

    • Fulvestrant injection is used alone or in combination with ribociclib (Kisqali®) to treat a certain type of hormone receptor positive, advanced breast cancer (breast cancer that depends on hormones such as estrogen to grow) or breast cancer has spread to other parts of the body in women who have experienced menopause (change of life; end of monthly menstrual periods) and have not previously been treated with an anti-estrogen medication such as tamoxifen (Nolvadex). Fulvestrant injection is also used alone or in combination with ribociclib (Kisqali®) to treat hormone receptor positive, advanced breast cancer or breast cancer that has spread to other parts of the body in women who have experienced menopause and whose breast cancer has worsened after they were treated with an anti-estrogen medication such as tamoxifen. Fulvestrant injection is also used in combination with palbociclib (Ibrance®) or abemaciclib (Verzenio®) to treat hormone receptor positive, advanced breast cancer in women whose breast cancer has spread to other parts of the body and has worsened after they were treated with anti-estrogen medication such as tamoxifen. Fulvestrant is in a class of medications called estrogen receptor antagonists. It works by blocking the action of estrogen on cancer cells. This can slow or stop the growth of some breast tumors that need estrogen to grow.