J9323 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J9323 summary

J9323 is a HCPCS Level II J-code used to bill pemetrexed ditromethamine, 10 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 J9323: Pemetrexed(J9323)

Code J9323 NDC-Crosswalk 2 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 codeJ9323

DescriptorInjection, pemetrexed ditromethamine, 10 mg

Billing unitNot available in current dataset

Payment limit / unit Not available in current dataset

Mapped NDCs2

Data periodNot available in current dataset

Last updatedSource date not available

🧾 Billing & reimbursement HCPCS · CMS

Medicare payment limit / unit

—

Est. ASP / unit

—

Est. after 2% sequester

—

HCPCS dosage

—

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).

Full HCPCS code details (official CMS record)

Long descriptionInjection, pemetrexed ditromethamine, 10 mg

CoverageC — Carrier/MAC judgment

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 date2023-07-01

Date added2023-07-01

Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J9323 = 1 unit. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (unit) 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 J9323 CROSSWALKED NDCs

2 NDCs map to J9323. Bill units = how many HCPCS units one package represents.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	NADAC / unit	Status	Source
00409-1060-01	PEMETREXED (SDV,PF,LATEX-FREE) 100 MG	Unknown	—	—	10	—	—	PDAC
00409-1061-01	PEMETREXED (SDV,PF,LATEX-FREE) 500 MG	Unknown	—	—	50	—	—	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 J9323 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J9323. 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 J9323
J9304	Inj. pemetrexed, 10 mg	10 MG	$7.994	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9305	Inj. pemetrexed nos 10mg	10 MG	$6.952	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9324	Inj, pemrydi rtu, 10 mg	10 MG	$67.935	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9292	PEMETREXED DIPOTASSIUM	10 MG	$73.670	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9294	Inj pemetrexed, hospira 10mg	10 MG	$2.943	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J9314	Inj pemetrexed (teva) 10mg	10 MG	$10.986	Related ingredient or formulation — confirm strength, form and billing unit before substituting.

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 · 2025 (Q1-Q4)

Total Part B spend

$78.7K

Claims

132

Beneficiaries

34

Spend / beneficiary

$2,314.24

Spend / claim

$596.09

Where J9323 ranks among Part B drugs · 2025 (Q1-Q4) · neighbors ±5

Total spending — #702 of 918

#697 CORTROSYN* J0834 $87K #698 MULTIHANCE MULTIPACK A9578 $86.1K #699 FETROJA J0699 $85.9K #700 DAPTOMYCIN(J0873) J0873 $84K #701 CLONIDINE HCL* J0735 $83.3K #702 PEMETREXED(J9323) J9323 $78.7K #703 MOXIFLOXACIN J2280 $76.1K #704 IBANDRONATE SODIUM J1740 $75.3K #705 COMIRNATY (5-11Y)* 91319 $72.8K #706 MIRCERA J0888 $71.9K #707 ENOXAPARIN SODIUM* J1650 $69.3K

Total claims — #764 of 918

#759 FLUMIST * 90660 138 #760 CALCITONIN-SALMON* J0630 136 #761 CHLOROPROCAINE HCL* J2401 135 #762 SIVEXTRO J3090 135 #763 PROGRAF(J7525)* J7525 132 #764 PEMETREXED(J9323) J9323 132 #765 BIZENGRI J9382 130 #766 DILTIAZEM HCL-0.9% N... J1163 129 #767 EVOMELA J9246 129 #768 ABILIFY ASIMTUFII J0402 128 #769 FLUCONAZOLE-NACL J1450 128

Full breakdown by period (1)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2025 (Q1-Q4)	$78.7K	34	132	$2,314.24	$596.09

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

Loaded

Payment limit & billing unit

CMS Medicare Part B ASP Pricing File (quarterly)

Not available

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 2025

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.

❓ J9323 billing FAQ

What is HCPCS code J9323?

J9323 is a HCPCS Level II J-code used to bill Injection, pemetrexed ditromethamine, 10 mg under Medicare Part B and most medical (not pharmacy) benefits.

Which NDCs bill under J9323?

2 NDCs currently map to J9323 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 J9323 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.

J9323 – Injection, pemetrexed ditromethamine, 10 mg · NDC Crosswalk & Billing Units