J9076 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J9076 summary

J9076 is a HCPCS Level II J-code used to bill cyclophos (baxter) 5mg, 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 J9076: Cyclophosphamide(J9076)

Code J9076 Billing unit 5 MG Payment limit $4.387/unit NDC-Crosswalk 2 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 codeJ9076

DescriptorInj, cyclophos (baxter) 5mg

Billing unit5 MG

Payment limit / unit$4.387

Est. ASP / unit$4.139 est.

Mapped NDCs2

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.

Read the full Cyclophosphamide drug guide →

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

$4.387

Est. ASP / unit

$4.139 est.

Est. after 2% sequester

$4.299

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.

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J9076 = 5 mg. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (mg) Frequency — every days Number of doses NDC / package billed (optional)

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 J9076 WITH EST. MEDICARE PAY

2 NDCs map to J9076. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($4.387/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
00338-9777-01	Cyclophosphamide 200 mg/mL INJECTION	Baxter	1 VIAL in 1 CARTON (0338-9777-01) / 2.5 m...	200 mg/mL	100	$438.70	—	● Active	CMS + PDAC
00338-9779-01	Cyclophosphamide 200 mg/mL INJECTION	Baxter	1 VIAL in 1 CARTON (0338-9779-01) / 5 mL...	200 mg/mL	200	$877.40	—	● 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.

⚠️ Don't confuse J9076 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J9076. Billing units and payment limits differ — confirm the exact code, strength and form before billing.

Code	Descriptor	Billing unit	Payment limit / unit	How it differs from J9076
J9072	Inj cyclophos dr.reddy's 5mg	5 MG	$8.922	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9073	CYCLOPHOSPHAMIDE	5 MG	$0.498	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9075	CYCLOPHOSPHAMIDE	5 MG	$0.575	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9074	CYCLOPHOSPHAMIDE	5 MG	$3.438	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9071	Inj cyclophosphamd auromedic	5 MG	$0.490	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J8530	Cyclophosphamide oral 25 mg	25 MG	$1.491	Different billing unit — 25 MG vs 5 MG

Related codes matched on shared ingredient (CMS Medicare Part B Spending feed). Billing units and payment limits from the CMS ASP Pricing File. Always verify the precise HCPCS code for the product and strength administered.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period

Total Part B spend

$332.9K

Claims

372

Beneficiaries

192

Spend / beneficiary

$1,734.08

Spend / claim

$895.01

Trend by period

Where J9076 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #479 of 824

#474 SUBLOCADE(Q9992) Q9992 $345.4K #475 CYCLOPHOSPHAMIDE(J90... J9074 $344K #476 IODIXANOL(Q9966)* Q9966 $341.3K #477 YESINTEK Q5100 $340.6K #478 ETOPOSIDE J8560 $337.5K #479 CYCLOPHOSPHAMIDE(J90... J9076 $332.9K #480 CIMERLI Q5128 $331.8K #481 MOZOBIL* J2562 $328.2K #482 NEOSTIM TL PER SQ CM... Q4265 $325.7K #483 COCOON MEMBRANE, PER... Q4264 $322.7K #484 DURAMORPH* J2274 $322.2K

Total claims — #484 of 824

#479 CLADRIBINE J9065 391 #480 FOLIC ACID J1808 386 #481 CYGNUS MATRIX, PER S... Q4199 381 #482 REVOSHIELD+ AMNIO, P... Q4289 376 #483 CLONIDINE HCL* J0735 372 #484 CYCLOPHOSPHAMIDE(J90... J9076 372 #485 PROVOCHOLINE J7674 371 #486 SIMPLIMAX, PER SQ CM... Q4341 365 #487 NALBUPHINE HCL J2300 362 #488 DIAZEPAM J3360 361 #489 EMRELIS J9326 358

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$332.9K	192	372	$1,734.08	$895.01
2025 (Q1-Q4)	$591.2K	281	673	$2,104.08	$878.53

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

$74.9K

Medicare paid

$58.7K

Submitted services

18,211

Denial rate

12.8%

Allowed / service

$4.72

Submitted charges

$142.1K

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 J9076 is utilized

⏳

The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.

📊 What bills under J9076

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

cyclophosphamide injection, soluti... 2

NDC products by labeler

Baxter Healthcare Company 2

🔗 Related NDC directory pages

🧪 All Cyclophosphamide Injection, Solution NDCsIngredient 🏭 All Baxter labeler NDCsLabeler 00338

🗃️ 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

Not available in current dataset

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)

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

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.

❓ J9076 billing FAQ

What is HCPCS code J9076?

J9076 is a HCPCS Level II J-code used to bill Inj, cyclophos (baxter) 5mg under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J9076?

One unit of J9076 represents 5 MG. Report the number of units equal to the dose administered divided by 5 MG.

How many units of J9076 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 J9076?

The Medicare Part B payment limit is $4.387 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $4.299 per unit. Payment limits are revised quarterly.

Which NDCs bill under J9076?

2 NDCs currently map to J9076 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 J9076 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.

J9076 – Inj, cyclophos (baxter) 5mg · NDC Crosswalk & Billing Units