J9052
J9052 – Injection, carmustine (accord), not therapeutically equivalent to j9050, · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 2 NDCs crosswalked
📋 J9052 summary
J9052 is a HCPCS Level II J-code used to bill carmustine (accord), not therapeutically equivalent to j9050, 100 mg. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
⚠ 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 codeJ9052
DescriptorInjection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg
Billing unitNot available in current dataset
Payment limit / unit Not available in current dataset
Mapped NDCs2
Data periodNot available in current dataset
Last updatedSource date not available
💊 About Carmustine DRUG GUIDE
Carmustine injection is used as palliative therapy — either alone or combined with other chemotherapy drugs — for several brain tumors, including glioblastoma, brainstem glioma, medulloblastoma, astrocytoma, ependymoma, and metastatic brain tumors.
It is also used for multiple myeloma (in combination with prednisone), and for relapsed or refractory Hodgkin's lymphoma and Non-Hodgkin's lymphomas (in combination with other approved drugs).Gliadel — a dissolving wafer form of carmustine placed directly into the brain during surgery — is specifically indicated for newly diagnosed high-grade glioma (as an addition to surgery and radiation) and for recurrent glioblastoma (as an addition to surgery).
Clinical overview from our editorial drug guide for Carmustine. For billing reference, see the sections above.
🧾 Billing & reimbursement HCPCS · CMS
Medicare payment limit / unit
—
Est. ASP / unit
—
Est. after 2% sequester
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HCPCS dosage
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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).
Full HCPCS code details (official CMS record)
Long descriptionInjection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment groupYY
Action codeA — Added this year
Effective date2024-01-01
Date added2024-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J9052 = 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 J9052 CROSSWALKED NDCs
2 NDCs map to J9052. Bill units = how many HCPCS units one package represents.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|
| 16729-0545-63 | CARMUSTINE (W/DILUENT,PF,LATEX-FREE) 50 MG | Unknown | — | — | 0.5 | — | — | PDAC |
| 16729-0548-63 | CARMUSTINE (W/DILUENT,PF,LATEX-FREE) 300 MG | Unknown | — | — | 3 | — | — | 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
No reportable public Medicare utilization was found for J9052. This is expected for newer codes, low-volume drugs, or codes whose use is billed under another code. CMS also hides any figure covering fewer than 11 patients (a privacy rule), so small-volume use may exist but isn't publishable. Utilization and spend appear here automatically once CMS publishes reportable data for this code.
🗃️ 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)
Not available
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
2 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
No reportable utilization
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.
❓ J9052 billing FAQ
What is HCPCS code J9052?
J9052 is a HCPCS Level II J-code used to bill Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg under Medicare Part B and most medical (not pharmacy) benefits.
Which NDCs bill under J9052?
2 NDCs currently map to J9052 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 J9052 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.