J9172
J9172 – Injection, docetaxel (ingenus) not therapeutically equivalent to j9171, · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 3 NDCs crosswalked per 1 MG $46.287/unit ASP+6%
📋 J9172 summary
J9172 is a HCPCS Level II J-code used to bill docetaxel (ingenus) not therapeutically equivalent to j9171, 1 mg, billed per 1 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 J9172: Docivyx
Code J9172
Billing unit 1 MG Payment limit $46.287/unit NDC-Crosswalk 3
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 codeJ9172
DescriptorInjection, docetaxel (ingenus) not therapeutically equivalent to j9171, 1 mg
Billing unit1 MG
Payment limit / unit$46.287
Est. ASP / unit$43.667 est.
Mapped NDCs3
Data periodQ3 2026
Last updated2026-08-20
💊 About Docetaxel DRUG GUIDE
Docetaxel injection treats several types of cancer.
It is used as a single agent or in combination with other chemotherapy drugs, depending on the cancer type and stage.Approved uses include: locally advanced or metastatic breast cancer after prior chemotherapy has failed; adjuvant (after-surgery) treatment of operable node-positive breast cancer (in combination with doxorubicin and cyclophosphamide); locally advanced or metastatic non-small cell lung cancer after platinum-based chemotherapy failure, or as first-line therapy with cisplatin; metastatic castration-resistant prostate cancer (with prednisone); advanced gastric adenocarcinoma including gastroesophageal junction cancer (with cisplatin and fluorouracil); and locally advanced squamous cell carcinoma of the head and neck (with cisplatin and fluorouracil).
Beizray, Docivyx, and Docetaxel injection products all carry these indications.
Clinical overview from our editorial drug guide for Docetaxel. 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
$46.287
Est. ASP / unit
$43.667 est.
Est. after 2% sequester
$45.361
HCPCS dosage
1 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, docetaxel (ingenus) not therapeutically equivalent to j9171, 1 mg
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment group—
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 J9172 = 1 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 J9172 WITH EST. MEDICARE PAY
3 NDCs map to J9172. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($46.287/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 83831-0101-02 | DOCIVYX docetaxel 20 mg/2mL INJECTION, SOLUTION | Avyxa | 1 VIAL, GLASS in 1 CARTON (83831-101-02)... | 20 mg/2mL | 20 | $925.74 | — | ● Active | CMS + PDAC |
| 83831-0102-08 | DOCIVYX docetaxel 80 mg/8mL INJECTION, SOLUTION | Avyxa | 1 VIAL, GLASS in 1 CARTON (83831-102-08)... | 80 mg/8mL | 80 | $3,702.96 | — | ● Active | CMS + PDAC |
| 83831-0103-16 | DOCIVYX docetaxel 160 mg/16mL INJECTION, SOLUTION | Avyxa | 1 VIAL, GLASS in 1 CARTON (83831-103-16)... | 160 mg/16mL | 160 | $7,405.92 | — | ● 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
$12.62M
Claims
2,049
Beneficiaries
873
Spend / beneficiary
$14,452.71
Spend / claim
$6,157.74
Trend by period
Where J9172 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #156 of 824
#151
IMJUDO J9347
$14.18M
#152
HERCEPTIN J9355
$13.84M
#153
LEVULAN J7308
$13.55M
#154
MEMBRANE GRAFT OR WR... Q4205
$13.47M
#155
RENFLEXIS Q5104
$12.69M
#156
DOCIVYX J9172
$12.62M
#157
ENJAYMO J1302
$12.53M
#158
KANJINTI Q5117
$12.45M
#159
MONJUVI J9349
$12.35M
#160
BAVENCIO J9023
$12.35M
#161
VYLOY J1326
$12.35M
Total claims — #310 of 824
#305
FERRLECIT* J2916
2,139
#306
CYCLOPHOSPHAMIDE(J85... J8530
2,107
#307
XEMBIFY J1558
2,103
#308
CYCLOPHOSPHAMIDE(J90... J9071
2,094
#309
OPTISON Q9956
2,093
#310
DOCIVYX J9172
2,049
#311
GAMMAGARD S-D J1566
2,043
#312
ZEPZELCA J9223
2,021
#313
PALINGEN OR PALINGEN... Q4173
2,012
#314
NYVEPRIA Q5122
2,011
#315
HERCEPTIN HYLECTA J9356
2,001
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) | $12.62M | 873 | 2,049 | $14,452.71 | $6,157.74 |
| 2025 (Q1-Q4) | $45.04M | 1,849 | 7,355 | $24,359.62 | $6,123.85 |
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
$44.1M
Medicare paid
$34.17M
Submitted services
918,905
Denial rate
5.6%
Allowed / service
$50.83
Submitted charges
$126.9M
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 J9172
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)
3 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.
❓ J9172 billing FAQ
What is HCPCS code J9172?
J9172 is a HCPCS Level II J-code used to bill Injection, docetaxel (ingenus) not therapeutically equivalent to j9171, 1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J9172?
One unit of J9172 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J9172 should I bill?
Divide the dose administered by the code's unit size (1 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 J9172?
The Medicare Part B payment limit is $46.287 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $45.361 per unit. Payment limits are revised quarterly.
Which NDCs bill under J9172?
3 NDCs currently map to J9172 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 J9172 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.