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J9029

J9029 – Injection, nadofaragene firadenovec-vncg, per therapeutic dose · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 1 NDC crosswalked per PER THERAPEUTIC DOSE $64,331.614/unit ASP+6%

This page is curated, coded, and maintained by

Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

📋 J9029 summary

J9029 is a HCPCS Level II J-code used to bill nadofaragene firadenovec-vncg, per therapeutic dose, billed per PER THERAPEUTIC DOSE. 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 J9029: Adstiladrin

Code J9029 Billing unit PER THERAPEUTIC DOSE Payment limit $64,331.614/unit NDC-Crosswalk 1 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 codeJ9029
DescriptorInjection, nadofaragene firadenovec-vncg, per therapeutic dose
Billing unitPER THERAPEUTIC DOSE
Payment limit / unit$64,331.614
Est. ASP / unit$60,690.202 est.
Mapped NDCs1
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
$64,331.614
Est. ASP / unit
$60,690.202 est.
Est. after 2% sequester
$63,044.982
HCPCS dosage
PER THERAPEUTIC DOSE
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, nadofaragene firadenovec-vncg, per therapeutic dose
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment groupYY
Action codeP — Payment change
Effective date2024-01-01
Date added2023-07-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J9029 = 1 unit. 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 J9029 WITH EST. MEDICARE PAY

1 NDC map to J9029. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($64,331.614/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
55566-1050-01 ADSTILADRIN nadofaragene firadenovec-vncg 300000000000 {VP}/mL SUSPENSION Ferring 4 VIAL in 1 CARTON (55566-1050-1) / 20 mL... 300000000000 {VP}/mL 1 $64,331.61 — ● Active CMS ASP
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
$31.33M
Claims
497
Beneficiaries
495
Spend / beneficiary
$63,295.40
Spend / claim
$63,040.69
Trend by period
Where J9029 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #99 of 824
#94 VYEPTI J3032 $31.97M #95 ENVARSUS XR J7503 $31.82M #96 ARALAST NP* J0256 $31.72M #97 CUVITRU J1555 $31.71M #98 NEULASTA ONPRO* J2506 $31.45M #99 ADSTILADRIN J9029 $31.33M #100 ZEPZELCA J9223 $31.07M #101 ARANESP(J0881) J0881 $31.07M #102 VEGZELMA Q5129 $30.16M #103 FLUZONE HIGH-DOSE * 90662 $29.64M #104 DATROWAY J9011 $29.34M
Total claims — #456 of 824
#451 ALBUMIN (HUMAN)* P9041 514 #452 BENDAMUSTINE HCL* J9033 507 #453 CEREZYME J1786 506 #454 IMLYGIC J9325 503 #455 MICAFUNGIN(J2248)* J2248 497 #456 ADSTILADRIN J9029 497 #457 XCELL AMNIO MATRIX P... Q4280 495 #458 EPICORD 1 SQ CM** Q4187 490 #459 IMJUDO J9347 489 #460 XIPERE J3299 487 #461 IMAAVY J9256 487

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $31.33M 495 497 $63,295.40 $63,040.69
2025 (Q1-Q4) $110.41M 988 1,783 $111,746.96 $61,921.48
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
$40.97M
Medicare paid
$46.39M
Submitted services
985
Denial rate
30.7%
Allowed / service
$59,979.62
Submitted charges
$59.93M
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.

🗃️ 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
1 NDC 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.

❓ J9029 billing FAQ

What is HCPCS code J9029?
J9029 is a HCPCS Level II J-code used to bill Injection, nadofaragene firadenovec-vncg, per therapeutic dose under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J9029?
One unit of J9029 represents PER THERAPEUTIC DOSE. Report the number of units equal to the dose administered divided by PER THERAPEUTIC DOSE.
How many units of J9029 should I bill?
Divide the dose administered by the code's unit size (PER THERAPEUTIC DOSE) 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 J9029?
The Medicare Part B payment limit is $64,331.614 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $63,044.982 per unit. Payment limits are revised quarterly.
Which NDCs bill under J9029?
1 NDC currently map to J9029 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 J9029 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.