J9266
J9266 – Injection, pegaspargase, per single dose vial · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 2 NDCs crosswalked per 1 EA $29,663.965/unit ASP+6%
📋 J9266 summary
J9266 is a HCPCS Level II J-code used to bill pegaspargase, per single dose vial, billed per 1 EA. 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 J9266: Oncaspar
Code J9266
Billing unit 1 EA Payment limit $29,663.965/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 codeJ9266
DescriptorInjection, pegaspargase, per single dose vial
Billing unit1 EA
Payment limit / unit$29,663.965
Est. ASP / unit$27,984.873 est.
Mapped NDCs2
Data periodQ3 2026
Last updated2026-08-20
💊 About Pegaspargase Injection DRUG GUIDE
Oncaspar (pegaspargase) injection is used as part of a multi-drug chemotherapy regimen to treat acute lymphoblastic leukemia (ALL) — a fast-growing cancer of the blood and bone marrow — in both pediatric and adult patients.
It is approved for first-line (initial) treatment of ALL.Oncaspar is also specifically approved for patients with ALL who have had a serious allergic reaction (hypersensitivity) to native forms of L-asparaginase, offering an option when other asparaginase products can no longer be used safely.
Clinical overview from our editorial drug guide for Pegaspargase Injection. 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
$29,663.965
Est. ASP / unit
$27,984.873 est.
Est. after 2% sequester
$29,070.686
HCPCS dosage
1 EA
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, pegaspargase, per single dose vial
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment groupYY
Action codeN — No maintenance this year
Effective date2009-01-01
Date added1996-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J9266 = 1 ea. 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 J9266 WITH EST. MEDICARE PAY
2 NDCs map to J9266. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($29,663.965/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 72694-0954-01 | ONCASPAR Pegaspargase 750 [iU]/mL INJECTION, SOLUTION | Servier | 1 VIAL, SINGLE-USE in 1 CARTON (72694-954-... | 750 [iU]/mL | 1 | $29,663.97 | — | ● Active | CMS + PDAC |
| 00944-3810-01 | ONCASPAR (S.D.V.,PF) 750 IU/1 ML | Unknown | — | — | 0.2 | $5,932.79 | — | — | 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
$417.8K
Claims
14
Beneficiaries
—
Spend / beneficiary
—
Spend / claim
$29,843.12
Trend by period
Where J9266 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #457 of 824
#452
ESPEROCT J7204
$454.6K
#453
ALPHANINE SD J7193
$450K
#454
CYCLOSPORINE MODIFIE... J7502
$434.7K
#455
APHEXDA J2277
$433.5K
#456
ALDURAZYME J1931
$424.1K
#457
ONCASPAR J9266
$417.8K
#458
ARISTADA J1944
$412.6K
#459
DEXAMETHASONE SODIUM... J1100
$404.4K
#460
LYUMJEV J1813
$402.9K
#461
MEMBRANE WRAP HYDR P... Q4290
$401.6K
#462
FULVESTRANT J9394
$400K
Total claims — #811 of 824
#806
HAVRIX* 90632
14
#807
CLINDAMYCIN-0.9% NAC... J0737
14
#808
COAGADEX J7175
14
#809
PROGRAF(J7525)* J7525
14
#810
CLOFARABINE* J9027
14
#811
ONCASPAR J9266
14
#812
BICILLIN C-R J0558
13
#813
ZINPLAVA J0565
13
#814
PELLOGRAFT, PER SQ C... Q4320
13
#815
RETACRIT(Q5105) Q5105
13
#816
ACETAMINOPHEN(J0134) J0134
12
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) | $417.8K | — | 14 | — | $29,843.12 |
| 2025 (Q1-Q4) | $1.84M | 25 | 66 | $73,711.56 | $27,921.05 |
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
—
Medicare paid
$264.9K
Submitted services
—
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 J9266
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)
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.
❓ J9266 billing FAQ
What is HCPCS code J9266?
J9266 is a HCPCS Level II J-code used to bill Injection, pegaspargase, per single dose vial under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J9266?
One unit of J9266 represents 1 EA. Report the number of units equal to the dose administered divided by 1 EA.
How many units of J9266 should I bill?
Divide the dose administered by the code's unit size (1 EA) 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 J9266?
The Medicare Part B payment limit is $29,663.965 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $29,070.686 per unit. Payment limits are revised quarterly.
Which NDCs bill under J9266?
2 NDCs currently map to J9266 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 J9266 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.