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    v1.0.30
    OpenPayerBilling CodesChemotherapy DrugsHCPCS hcpcs-j9000-doxorubicin-10mg-injection
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    HCPCS J9000: Doxorubicin Hydrochloride Injection, 10 mg

    Commercial payers pay $5 on average nationally for this procedure.

    HCPCS Level II code J9000 describes an injection of doxorubicin hydrochloride, 10 mg, an antineoplastic chemotherapy agent typically administered as an intravenous chemotherapy infusion for treatment of malignant neoplasms; the service is generally provided in oncology outpatient infusion centers or hospital outpatient departments.

    For related coverage guidance, see recent payer policy updates: Hematology - Adzynma, Tumor Treating Fields for Pancreatic Cancer, Axicabtagene ciloleucel (Yescarta®) coverage.

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    National Reimbursement Benchmarks

    National commercial rates for J9000 cluster around BUCA’s average commercial benchmark of $5.3, with notable variation among major carriers. Blue Cross Blue Shield shows a relatively tight interquartile spread (P75–P25 = $1.8), and UnitedHealth Group is also compact (spread = $1.2), indicating concentration near their medians. Aetna and Cigna display wider dispersion driven by higher upper tails; Aetna’s interquartile spread is $2.4 while Cigna’s is $1.0, but Aetna’s maximum rate ($92.9) and Cigna’s high maximum ($66.0) create broader overall variability beyond the IQRs.

    Comparing central tendencies, most payers cluster near BUCA’s mean of $5.3 and Cigna and Aetna share median values at $3.0, whereas Blue Cross Blue Shield and UnitedHealth Group medians are slightly higher at $4.5 and $3.2 respectively. The tightest IQRs belong to UnitedHealth Group and Blue Cross Blue Shield, while Aetna exhibits the widest overall dispersion when considering its extreme maximum.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with newly diagnosed metastatic breast cancer presents to the oncology infusion center for systemic chemotherapy. The treating medical oncologist has prescribed doxorubicin hydrochloride for cytotoxic therapy. The drug is supplied and billed as J9000 representing 10 mg units of doxorubicin hydrochloride. The clinical workflow includes verification of diagnosis and chemotherapy regimen, informed consent, baseline labs (CBC with differential, comprehensive metabolic panel including hepatic and renal function), review of prior anthracycline exposure and cumulative dose, assessment of cardiac function (recent echocardiogram or MUGA scan documenting left ventricular ejection fraction), placement of appropriate IV access (peripheral or central line), premedication as indicated (antiemetics, IV fluids), preparation and verification of the chemotherapy dose by pharmacy, bedside barcode and patient identity checks, administration of the dilution/infusion per institutional protocol, monitoring for infusion reactions and extravasation, documentation of total mg administered (correlated to units billed as J9000), and post-infusion observation with discharge instructions. Typical sites of service are outpatient hospital infusion centers, physician office infusion suites, or outpatient oncology clinics. This medication is used across multiple solid tumors listed in the patient’s problem list such as C50.911, C34.90, C18.9, C61, and C25.9, where doxorubicin is indicated as part of first-line or combination regimens. Billing reflects each 10 mg increment of drug supplied, with modifiers applied as appropriate for facility, professional component, partial administrations, wastage, or other circumstance-specific adjustments.

    Related CPT Codes

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0003X
    207RX0202X
    2084P0800X
    364SW0102X
    374K00000X
    163WW0000X
    211D00000X
    207ZD0900X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    C04.9Malignant neoplasm of floor of mouth, unspecified
    C15.9Malignant neoplasm of esophagus, unspecified
    C16.9Malignant neoplasm of stomach, unspecified
    C18.9Malignant neoplasm of colon, unspecified
    C20Malignant neoplasm of rectum
    C21.0Malignant neoplasm of anus, unspecified
    C22.0Liver cell carcinoma
    C25.9Malignant neoplasm of pancreas, unspecified
    C30.0Malignant neoplasm of nasal cavity
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    Hematology - AdzynmaCigna2026-10-15
    Tumor Treating Fields for Pancreatic Cancerselect_health2026-10-01
    Axicabtagene ciloleucel (Yescarta®) coverageBaylor Scott & White Health Plan2026-10-01
    Electric Tumor Treatment Field Therapy (for Kentucky Only)UnitedHealthcare2026-10-01
    Electric Tumor Treatment Field Therapy (for Kansas Only)UnitedHealthcare2026-10-01
    Electric Tumor Treatment Field Therapy (for Idaho Only)UnitedHealthcare2026-10-01
    Brexucabtagene autoleucel (Tecartus) CoverageBaylor Scott & White Health Plan2026-10-01
    Electric Tumor Treatment Field Therapy (for Pennsylvania Only)UnitedHealthcare2026-10-01
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Factor VIII ProductsCigna2026-09-15

    Related Codes

    HCPCS-J9003-LEUPROLIDE-INJECTABLE-CAMCEVI-1MG

    HCPCS Level II J9003: Leuprolide injectable (camcevi etm), 1 mg

    HCPCS-J9010-ALEMTUZUMAB-INJECTION-10MG

    HCPCS Level II J9010: Injection, alemtuzumab, 10 mg

    HCPCS-J9011-DATOPOTAMAB-DERUXTECAN-INJECTION-1MG

    HCPCS J9011: Datopotamab Deruxtecan Injection, 1 mg

    HCPCS-J9015-ALDESLEUKIN-INJECTION-SINGLE-USE-VIAL

    HCPCS Level II J9015: Aldesleukin Injection, Single-Use Vial

    HCPCS-J9017-ARSENIC-TRIOXIDE-INJECTION-1MG

    HCPCS J9017: Arsenic Trioxide Injection, 1 mg

    HCPCS-J9019-ASPARAGINASE-ERWINAZE-INJECTION-1000-IU

    HCPCS Level II J9019: Asparaginase (Erwinaze) Injection, 1,000 IU

    HCPCS-J9020-ASPARAGINASE-INJECTION-10000-UNITS

    HCPCS J9020: Asparaginase Injection, 10,000 Units

    HCPCS-J9021-ASPARAGINASE-RYLAZE-INJECTION-0-1-MG

    HCPCS Level II J9021: Injection, asparaginase (Rylaze), 0.1 mg

    HCPCS-J9022-ATEZOLIZUMAB-INJECTION-10MG

    HCPCS J9022: Injection, atezolizumab 10 mg

    HCPCS-J9023-AVELUMAB-10MG-INJECTION

    HCPCS J9023: Avelumab Injection, 10 mg

    Showing 1–10 of 227

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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    CPT CodeDescriptionRelationship to This Procedure
    J9001Injection, doxorubicin hydrochloride, all lipid formulations, 10 mgAlternate HCPCS-level code for lipid formulations of doxorubicin; billed when lipid formulation is used instead of standard doxorubicin (J9000).