J9072
J9072 – Injection, cyclophosphamide, (dr. reddy's), 5 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 6 NDCs crosswalked per 5 MG $8.922/unit ASP+6%
📋 J9072 summary
J9072 is a HCPCS Level II J-code used to bill cyclophosphamide, (dr. reddy's), 5 mg, billed per 5 MG. 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 J9072: Cyclophosphamide(J9072)*, Cyclophosphamide, Frindovyx
Code J9072
Billing unit 5 MG Payment limit $8.922/unit NDC-Crosswalk 6
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 codeJ9072
DescriptorInjection, cyclophosphamide, (dr. reddy's), 5 mg
Billing unit5 MG
Payment limit / unit$8.922
Est. ASP / unit$8.417 est.
Mapped NDCs6
Data periodQ3 2026
Last updated2026-08-20
💊 About Cyclophosphamide DRUG GUIDE
Cyclophosphamide is used to treat many types of cancer in adults and children, including malignant lymphomas (such as Hodgkin's disease and Burkitt's lymphoma), multiple myeloma, several forms of leukemia, breast cancer, ovarian cancer, neuroblastoma, retinoblastoma, and advanced mycosis fungoides (a type of skin lymphoma).
It is often given alongside other chemotherapy drugs rather than on its own.Oral and injectable powder formulations (but not the Cyclophosphamide Injection solution concentrate) are also approved for minimal change nephrotic syndrome — a kidney condition — in children who have not responded well to, or cannot tolerate, steroid therapy.
The injectable solution concentrate is approved for adult patients only due to its alcohol content, and is not approved for use in children.
Clinical overview from our editorial drug guide for Cyclophosphamide. For billing reference, see the sections above.
🧾 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
$8.922
Est. ASP / unit
$8.417 est.
Est. after 2% sequester
$8.744
HCPCS dosage
5 MG
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, cyclophosphamide, (dr. reddy's), 5 mg
CoverageC — Carrier/MAC judgment
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 J9072 = 5 mg. 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 J9072 WITH EST. MEDICARE PAY
6 NDCs map to J9072. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($8.922/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 83831-0116-01 | Cyclophosphamide 500 mg/mL INJECTION | Avyxa | 1 VIAL, SINGLE-DOSE in 1 CARTON (83831-116... | 500 mg/mL | 100 | $892.20 | — | ● Active | CMS + PDAC |
| 83831-0117-02 | Cyclophosphamide 1 g/2mL INJECTION | Avyxa | 1 VIAL, SINGLE-DOSE in 1 CARTON (83831-117... | 1 g/2mL | 200 | $1,784.40 | — | ● Active | CMS + PDAC |
| 83831-0118-04 | Cyclophosphamide 2 g/4mL INJECTION | Avyxa | 1 VIAL, SINGLE-DOSE in 1 CARTON (83831-118... | 2 g/4mL | 400 | $3,568.80 | — | ● Active | CMS + PDAC |
| 83831-0119-01 | Frindovyx Cyclophosphamide 500 mg/mL INJECTION | AVYXA | 1 VIAL, MULTI-DOSE in 1 CARTON (83831-119-... | 500 mg/mL | 100 | $892.20 | — | ● Active | CMS + PDAC |
| 83831-0120-02 | Frindovyx Cyclophosphamide 1 g/2mL INJECTION | AVYXA | 1 VIAL, MULTI-DOSE in 1 CARTON (83831-120-... | 1 g/2mL | 200 | $1,784.40 | — | ● Active | CMS + PDAC |
| 83831-0121-04 | Frindovyx Cyclophosphamide 2 g/4mL INJECTION | AVYXA | 1 VIAL, MULTI-DOSE in 1 CARTON (83831-121-... | 2 g/4mL | 400 | $3,568.80 | — | ● Active | CMS + 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
$4.47M
Claims
2,490
Beneficiaries
992
Spend / beneficiary
$4,508.85
Spend / claim
$1,796.30
Trend by period
Where J9072 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #249 of 824
#244
LUCENTIS J2778
$4.78M
#245
GIVLAARI J0223
$4.73M
#246
VONVENDI J7179
$4.7M
#247
HYALGAN* J7321
$4.54M
#248
INVEGA SUSTENNA J2426
$4.49M
#249
CYCLOPHOSPHAMIDE(J90... J9072
$4.47M
#250
TOFIDENCE Q5133
$4.45M
#251
HERZUMA Q5113
$4.43M
#252
GENVISC 850 J7320
$4.4M
#253
LANREOTIDE ACETATE(J... J1932
$4.36M
#254
PURAPLY AM 1 SQ CM** Q4196
$4.19M
Total claims — #289 of 824
#284
EOVIST A9581
2,602
#285
COMPLETE FT PER SQ C... Q4271
2,572
#286
REMODULIN* J3285
2,534
#287
SKYRIZI J2327
2,523
#288
QUTENZA J7336
2,519
#289
CYCLOPHOSPHAMIDE(J90... J9072
2,490
#290
AFLURIA (90658)* 90658
2,467
#291
CAMCEVI J1952
2,453
#292
TRELSTAR J3315
2,409
#293
RYBREVANT J9061
2,396
#294
BETHKIS* J7682
2,369
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) | $4.47M | 992 | 2,490 | $4,508.85 | $1,796.30 |
| 2025 (Q1-Q4) | $8.73M | 1,377 | 4,723 | $6,339.67 | $1,848.34 |
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
$8.6M
Medicare paid
$6.64M
Submitted services
1,016,183
Denial rate
6.7%
Allowed / service
$9.07
Submitted charges
$24.98M
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.
📊 What bills under J9072
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)
6 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.
❓ J9072 billing FAQ
What is HCPCS code J9072?
J9072 is a HCPCS Level II J-code used to bill Injection, cyclophosphamide, (dr. reddy's), 5 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J9072?
One unit of J9072 represents 5 MG. Report the number of units equal to the dose administered divided by 5 MG.
How many units of J9072 should I bill?
Divide the dose administered by the code's unit size (5 MG) 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 J9072?
The Medicare Part B payment limit is $8.922 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $8.744 per unit. Payment limits are revised quarterly.
Which NDCs bill under J9072?
6 NDCs currently map to J9072 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 J9072 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.