J9076
J9076 – Inj, cyclophos (baxter) 5mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 2 NDCs crosswalked per 5 MG $4.387/unit ASP+6%
📋 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 updated2026-09-20
💊 About Cyclophosphamide DRUG GUIDE
Cyclophosphamide is used mainly to treat cancers in adults and, for most products, in children.
These include malignant lymphomas (including Hodgkin's disease and Burkitt's lymphoma), multiple myeloma, leukemias, mycosis fungoides, neuroblastoma, ovarian adenocarcinoma, retinoblastoma and breast cancer.
It is often used with other cancer drugs.Some products are also approved for children with biopsy-proven minimal change nephrotic syndrome (a kidney condition) who did not respond to steroids or cannot tolerate them.
This use appears on the Cyclophosphamide capsule, tablet and some injection powder labels.
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.
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.
📊 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
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) | $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
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
Not available in current dataset
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-09-20
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.
For professional billing reference only — verify against the current CMS files before submitting claims.