J9248
J9248 – Inj melphalan (hepzato) 1 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 2 NDCs crosswalked per 1 MG $801.479/unit ASP+6%
📋 J9248 summary
J9248 is a HCPCS Level II J-code used to bill melphalan (hepzato) 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 J9248: Hepzato, Hepzato Kit
Code J9248
Billing unit 1 MG Payment limit $801.479/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 codeJ9248
DescriptorInj melphalan (hepzato) 1 mg
Billing unit1 MG
Payment limit / unit$801.479
Est. ASP / unit$756.112 est.
Mapped NDCs2
Data periodQ3 2026
Last updated2026-08-20
🧾 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
$801.479
Est. ASP / unit
$756.112 est.
Est. after 2% sequester
$785.449
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.
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J9248 = 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 J9248 WITH EST. MEDICARE PAY
2 NDCs map to J9248. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($801.479/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 75833-0601-01 | Hepzato Kit melphalan hydrochloride injection, powder, lyophilized, for solution KIT | Delcath | 1 KIT in 1 BOX (75833-601-01) * 5 VIAL,... | — | 250 | $200,369.75 | — | ● Active | CMS ASP |
| 75833-0601-02 | Hepzato Kit melphalan hydrochloride injection, powder, lyophilized, for solution KIT | Delcath | 1 KIT in 1 BOX (75833-601-02) * 5 VIAL,... | — | 250 | $200,369.75 | — | ● Active | CMS ASP |
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
$6.12M
Claims
35
Beneficiaries
25
Spend / beneficiary
$244,907.38
Spend / claim
$174,933.84
Trend by period
Where J9248 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #222 of 824
#217
CRYSVITA J0584
$6.3M
#218
GLASSIA J0257
$6.24M
#219
BENEFIX J7195
$6.21M
#220
FERAHEME(Q0138)* Q0138
$6.16M
#221
AMELUZ J7345
$6.15M
#222
HEPZATO J9248
$6.12M
#223
ADAKVEO J0791
$5.99M
#224
BESPONSA J9229
$5.95M
#225
AKYNZEO J1454
$5.95M
#226
KERECIS OMEGA3, PER... Q4158
$5.93M
#227
HERCESSI Q5146
$5.85M
Total claims — #728 of 824
#723
VANCOMYCIN HCL(J3374... J3374
38
#724
PERSERIS J2798
37
#725
XYNTHA SOLOFUSE* J7185
37
#726
PEMETREXED(J9314) J9314
37
#727
TYZAVAN* J3375
35
#728
HEPZATO J9248
35
#729
HYCAMTIN J8705
34
#730
LAMZEDE J0217
33
#731
ZEMDRI J0291
33
#732
DOXY 100* J1271
33
#733
HALOPERIDOL LACTATE J1630
33
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) | $6.12M | 25 | 35 | $244,907.38 | $174,933.84 |
| 2025 (Q1-Q4) | $15.67M | 39 | 89 | $401,762.17 | $176,053.09 |
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.
🗃️ 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
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.
❓ J9248 billing FAQ
What is HCPCS code J9248?
J9248 is a HCPCS Level II J-code used to bill Inj melphalan (hepzato) 1 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J9248?
One unit of J9248 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J9248 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 J9248?
The Medicare Part B payment limit is $801.479 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $785.449 per unit. Payment limits are revised quarterly.
Which NDCs bill under J9248?
2 NDCs currently map to J9248 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 J9248 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.