J2469
J2469 – Injection, palonosetron hcl, 25 mcg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 30 NDCs crosswalked per 25 MCG $0.574/unit ASP+6%
📋 J2469 summary
J2469 is a HCPCS Level II J-code used to bill palonosetron hcl, 25 mcg, billed per 25 MCG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Brand names associated with J2469: Palonosetron Hydrochloride, Palonosetron
Code J2469
Billing unit 25 MCG Payment limit $0.574/unit NDC-Crosswalk 30
Quarter Q3 2026
RxCUI Atlas Trace the drug concept →
⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.
🗂️ Key billing facts
HCPCS codeJ2469
DescriptorInjection, palonosetron hcl, 25 mcg
Billing unit25 MCG
Payment limit / unit$0.574
Est. ASP / unit$0.542 est.
Mapped NDCs30
Data periodQ3 2026
Last updated2026-08-20
🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026
📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$0.574
Est. ASP / unit
$0.542 est.
Est. after 2% sequester
$0.563
HCPCS dosage
25 MCG
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionInjection, palonosetron hcl, 25 mcg
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment group—
Action codeP — Payment change
Effective date2024-01-01
Date added2005-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J2469 = 25 mcg. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.
🔁 NDCs that bill under J2469 WITH EST. MEDICARE PAY
30 NDCs map to J2469. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.574/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00409-2504-10 | Palonosetron | Pfizer | — | — | 10 | $5.74 | — | — | CMS + PDAC |
| 00703-4094-01 | Palonosetron Hydrochloride .25 mg/5mL INJECTION, SOLUTION | Teva | 1 VIAL, SINGLE-USE in 1 CARTON (0703-4094-... | .25 mg/5mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 00781-3312-75 | Palonosetron Hydrochloride .25 mg/5mL INJECTION, SOLUTION | Sandoz | 1 VIAL, SINGLE-DOSE in 1 CARTON (0781-3312... | .25 mg/5mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 00781-3312-95 | Palonosetron Hydrochloride .25 mg/5mL INJECTION, SOLUTION | Sandoz | 10 VIAL, SINGLE-DOSE in 1 CARTON (0781-331... | .25 mg/5mL | 100 | $57.40 | — | ● Active | CMS + PDAC |
| 00781-3415-75 | Palonosetron Hydrochloride .25 mg/5mL INJECTION, SOLUTION | Sandoz | 1 VIAL, SINGLE-DOSE in 1 CARTON (0781-3415... | .25 mg/5mL | 10 | $5.74 | — | Obsolete | CMS + PDAC |
| 00781-3415-95 | Palonosetron Hydrochloride .25 mg/5mL INJECTION, SOLUTION | Sandoz | 10 VIAL, SINGLE-DOSE in 1 CARTON (0781-341... | .25 mg/5mL | 100 | $57.40 | — | Obsolete | CMS ASP |
| 16714-0834-01 | Palonosetron .05 mg/mL INJECTION, SOLUTION | NorthStar | 1 VIAL, SINGLE-USE in 1 CARTON (16714-834-... | .05 mg/mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 25021-0783-05 | palonosetron hydrochloride .05 mg/mL INJECTION, SOLUTION | Sagent | 1 VIAL in 1 CARTON (25021-783-05) / 5 mL... | .05 mg/mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 25021-0788-74 | Palonosetron | Sagent | — | — | 50 | $28.70 | — | — | CMS + PDAC |
| 36000-0326-02 | Palonosetron Hydrochloride .25 mg/5mL INJECTION | Baxter | 1 VIAL in 1 CARTON (36000-326-02) / 5 mL... | .25 mg/5mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 55111-0694-07 | Palonosetron .05 mg/mL INJECTION, SOLUTION | Dr.Reddy's | 1 VIAL, SINGLE-USE in 1 CARTON (55111-694-... | .05 mg/mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 55150-0186-05 | Palonosetron Hydrochloride .25 mg/5mL INJECTION, SOLUTION | Eugia | 1 VIAL, SINGLE-USE in 1 CARTON (55150-186-... | .25 mg/5mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 60505-6193-01 | Palonosetron .25 mg/5mL INJECTION | Apotex | 1 VIAL in 1 CARTON (60505-6193-1) / 5 mL... | .25 mg/5mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 60505-6193-04 | Palonosetron .25 mg/5mL INJECTION | Apotex | 10 VIAL in 1 CARTON (60505-6193-4) / 5 mL... | .25 mg/5mL | 100 | $57.40 | — | ● Active | CMS + PDAC |
| 60505-6439-01 | Palonosetron .25 mg/5mL INJECTION | Apotex | 1 VIAL in 1 CARTON (60505-6439-1) / 5 mL... | .25 mg/5mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 63323-0673-05 | Palonosetron .25 mg/5mL INJECTION, SOLUTION | Fresenius | 1 VIAL, SINGLE-DOSE in 1 CARTON (63323-673... | .25 mg/5mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 63323-0673-89 | Palonosetron .25 mg/5mL INJECTION, SOLUTION | Fresenius | 10 SYRINGE, PLASTIC in 1 CARTON (63323-673... | .25 mg/5mL | 100 | $57.40 | — | ● Active | CMS + PDAC |
| 67457-0317-25 | Palonosetron Hydrochloride .25 mg/5mL INJECTION, SOLUTION | Mylan | 1 VIAL, SINGLE-DOSE in 1 CARTON (67457-317... | .25 mg/5mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 68001-0355-25 | Palonosetron .05 mg/mL INJECTION, SOLUTION | BluePoint | 1 VIAL, SINGLE-USE in 1 CARTON (68001-355-... | .05 mg/mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 69543-0371-10 | Palonosetron | Virtus | — | — | 100 | $57.40 | — | — | CMS + PDAC |
| 70860-0785-05 | Palonosetron | Athenex | — | — | 10 | $5.74 | — | — | CMS ASP |
| 71288-0409-05 | Palonosetron Hydrochloride .25 mg/5mL INJECTION, SOLUTION | Meitheal | 1 VIAL, SINGLE-DOSE in 1 CARTON (71288-409... | .25 mg/5mL | 10 | $5.74 | — | ● Active | CMS + PDAC |
| 83634-0777-05 | Palonosetron Hydrochloride .05 mg/mL INJECTION, SOLUTION | Avenacy, | 1 VIAL, SINGLE-DOSE in 1 CARTON (83634-777... | .05 mg/mL | 10 | $5.74 | — | Obsolete | CMS ASP |
| 00143-9513-01 | PALONOSETRON HCL (PF) 0.125 MG/1 ML | Unknown | — | — | 5 | $2.87 | — | — | PDAC |
| 68001-0482-25 | PALONOSETRON HCL (SDV) 0.05 MG/1 ML | Unknown | — | — | 2 | $1.15 | — | — | PDAC |
| 50742-0485-05 | PALONOSETRON HCL (SDV) 0.05 MG/1 ML | Unknown | — | — | 2 | $1.15 | — | — | PDAC |
| 69097-0439-35 | PALONOSETRON HCL 0.05 MG/1 ML | Unknown | — | — | 2 | $1.15 | — | — | PDAC |
| 69639-0103-01 | ALOXI (PF,LATEX-FREE) 0.05 MG/1 ML | Unknown | — | — | 2 | $1.15 | — | — | PDAC |
| 16729-0365-66 | PALONOSETRON HCL 0.05 MG/1 ML | Unknown | — | — | 2 | $1.15 | — | — | PDAC |
| 69097-0927-35 | palonosetron hydrochloride .25 mg/5mL INJECTION | Cipla | 1 VIAL in 1 CARTON (69097-927-35) / 5 mL... | .25 mg/5mL | 2 | $1.15 | — | ● Active | PDAC |
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$150.2K
Claims
41,742
Beneficiaries
13,755
Spend / beneficiary
$10.92
Spend / claim
$3.60
Trend by period
Where J2469 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #541 of 824
#536
FIBRYGA J7177
$178.7K
#537
AMNIOBAND, GUARDIAN... Q4151
$163K
#538
VALRUBICIN* J9357
$159K
#539
DERMABIND FM, PER SQ... Q4313
$158.6K
#540
DACOGEN* J0894
$156.7K
#541
PALONOSETRON HCL J2469
$150.2K
#542
VAXNEUVANCE 90671
$149.4K
#543
DEXRAZOXANE J1190
$142.3K
#544
VITOGRAFT, PER SQ CM... Q4317
$140.8K
#545
NIPENT J9268
$139.7K
#546
CIDOFOVIR J0740
$139.4K
Total claims — #57 of 824
#52
HYALGAN* J7321
48,959
#53
INFLIXIMAB* J1745
48,117
#54
ARANESP(J0881) J0881
47,666
#55
ONDANSETRON HCL(J240... J2405
43,411
#56
CINVANTI J0185
42,275
#57
PALONOSETRON HCL J2469
41,742
#58
SYFOVRE J2781
41,654
#59
IZERVAY J2782
41,264
#60
GAMMAKED* J1561
40,877
#61
XOLAIR J2357
40,450
#62
SODIUM CHLORIDE(J704... J7040
40,325
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $150.2K | 13,755 | 41,742 | $10.92 | $3.60 |
| 2025 (Q1-Q4) | $1.11M | 40,339 | 232,163 | $27.59 | $4.79 |
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.
📈 Medicare Part B claims detail CMS PSPS · 2024
Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$1.12M
Medicare paid
$862.7K
Submitted services
2,448,394
Denial rate
4.8%
Allowed / service
$0.48
Submitted charges
$130.02M
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.
🗺️ Where J2469 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 2,556,985 services across 51 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.
📊 What bills under J2469
J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.
NDC products by ingredient
NDC products by labeler
🗃️ Data sources & freshness
Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
30 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Not available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.
⚠️ Practical billing caveats
- A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
- Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
- Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
- Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
- The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
- Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.
❓ J2469 billing FAQ
What is HCPCS code J2469?
J2469 is a HCPCS Level II J-code used to bill Injection, palonosetron hcl, 25 mcg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J2469?
One unit of J2469 represents 25 MCG. Report the number of units equal to the dose administered divided by 25 MCG.
How many units of J2469 should I bill?
Divide the dose administered by the code's unit size (25 MCG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J2469?
The Medicare Part B payment limit is $0.574 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.563 per unit. Payment limits are revised quarterly.
Which NDCs bill under J2469?
30 NDCs currently map to J2469 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J2469 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.