J9999
J9999 – Not otherwise classified, antineoplastic drugs · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 4 NDCs crosswalked
📋 J9999 summary
J9999 is a HCPCS Level II J-code used to bill Not otherwise classified, antineoplastic drugs. 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 J9999: Imlygic, Yondelis, Libtayo
⚠ 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 codeJ9999
DescriptorNot otherwise classified, antineoplastic drugs
Billing unitNot available in current dataset
Payment limit / unit Not available in current dataset
Mapped NDCs4
Data periodNot available in current dataset
Last updatedSource date not available
💊 About Cemiplimab-rwlc Injection DRUG GUIDE
Libtayo (cemiplimab-rwlc) is used to treat adults with cutaneous squamous cell carcinoma (CSCC) — a type of skin cancer — when it has spread (metastatic) or is locally advanced and cannot be removed with surgery or cured with radiation.
It is also used after surgery and radiation in adults with CSCC at high risk of the cancer coming back.Libtayo is also approved for adults with locally advanced or metastatic basal cell carcinoma (BCC) who have already tried a hedgehog pathway inhibitor or for whom that treatment is not suitable.
For non-small cell lung cancer (NSCLC), Libtayo may be used alone (in tumors with high PD-L1 expression) or combined with platinum-based chemotherapy as a first-line treatment, in patients without certain genetic changes (EGFR, ALK, or ROS1 aberrations) whose cancer is locally advanced or metastatic.
Clinical overview from our editorial drug guide for Cemiplimab-rwlc Injection. For billing reference, see the sections above.
🧾 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 descriptionNot otherwise classified, antineoplastic drugs
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1D
ASC payment group—
Action codeN — No maintenance this year
Effective date1997-01-01
Date added1986-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J9999 = 1 unit. 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 J9999 CROSSWALKED NDCs
4 NDCs map to J9999. Bill units = how many HCPCS units one package represents.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|
| 55513-0078-01 | Imlygic talimogene laherparepvec 1000000 [PFU]/mL INJECTION, SUSPENSION | Amgen | 1 VIAL in 1 CARTON (55513-078-01) / 1 mL... | 1000000 [PFU]/mL | 1 | — | ● Active | PDAC |
| 55513-0079-01 | Imlygic talimogene laherparepvec 100000000 [PFU]/mL INJECTION, SUSPENSION | Amgen | 1 VIAL in 1 CARTON (55513-079-01) / 1 mL... | 100000000 [PFU]/mL | 1 | — | ● Active | PDAC |
| 59676-0610-01 | YONDELIS Trabectedin .05 mg/mL INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | Janssen | 20 mL in 1 VIAL, SINGLE-USE (59676-610-01) | .05 mg/mL | 1 | — | ● Active | PDAC |
| 61755-0008-01 | LIBTAYO cemiplimab-rwlc 50 mg/mL INJECTION | Regeneron | 1 VIAL, SINGLE-USE in 1 CARTON (61755-008-... | 50 mg/mL | 1 | — | ● Active | 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 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
$18.73M
Medicare paid
$18.08M
Submitted services
380,352
Denial rate
80.0%
Allowed / service
$245.78
Submitted charges
$86.03M
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 J9999 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 1,894 services across 4 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.
📊 What bills under J9999
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)
Not available
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
4 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
No reportable utilization
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.
❓ J9999 billing FAQ
What is HCPCS code J9999?
J9999 is a HCPCS Level II J-code used to bill Not otherwise classified, antineoplastic drugs under Medicare Part B and most medical (not pharmacy) benefits.
Which NDCs bill under J9999?
4 NDCs currently map to J9999 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 J9999 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.