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    v1.0.30
    OpenPayerBilling CodesChemotherapy DrugsHCPCS hcpcs-j9010-alemtuzumab-injection-10mg
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    HCPCS Level II J9010: Injection, alemtuzumab, 10 mg

    HCPCS Level II code J9010 represents an injection of alemtuzumab, 10 mg used for systemic administration; the service is a therapeutic monoclonal antibody infusion/injection typically delivered in an infusion center or hospital outpatient setting for treatment of certain hematologic or oncologic conditions.

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    National Reimbursement Benchmarks

    Commercial national benchmarks for J9010 center on a BUCA average commercial rate of $701.5, positioning it between Blue Cross Blue Shield and Cigna. Blue Cross Blue Shield’s distribution is very tight with a P75–P25 range of $28.0 (P75 $663.4 minus P25 $663.4 yields $0.0 actual spread if using given identical percentiles, but using provided values the computed interquartile difference is $0.0), while Cigna shows a markedly wider interquartile spread of $179.0 ($873.0 minus $694.3). Blue Cross Blue Shield’s mean and median cluster near the top of its narrow band around $659–$663, whereas Cigna’s higher mean and max elevate its central tendency despite greater dispersion.

    Variation implies differing contract dynamics: Blue Cross Blue Shield exhibits the tightest rate clustering, BUCA sits at a higher average without min/max reporting, and Cigna displays the widest IQR-driven dispersion reflecting broader pricing outcomes. These comparisons highlight where commercial rate concentration is strongest and where price variability is most pronounced.

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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 female patient with metastatic breast cancer (diagnosis C50.911) presents to an outpatient infusion center for administration of alemtuzumab (J9010, 10 mg per unit) as part of a targeted immunotherapy regimen for refractory or relapsed hematologic or solid tumor disease where alemtuzumab use is clinically indicated. The typical workflow begins with oncologist evaluation in clinic (medical oncology or hematology-oncology), verification of diagnosis and indication, review of prior therapies and laboratory baseline (CBC with differential, renal and hepatic panels), and documentation of informed consent. On the day of service the infusion nurse confirms identity, performs pre-infusion vital signs and allergy check, prepares the appropriate dose of alemtuzumab per protocol, and establishes IV access. Premedications (e.g., acetaminophen, antihistamine, corticosteroid) are administered per institutional guidelines. Alemtuzumab is infused with continuous monitoring for infusion reactions; vital signs and nursing documentation are recorded at defined intervals. Post-infusion observation, adverse event documentation, and discharge instructions are completed. Billing captures the drug using J9010 (injection, alemtuzumab, 10 mg), with diagnosis linkage to one or more relevant ICD-10 codes such as C50.911, C34.90, C22.8, C56.9, or C79.51 depending on the malignancy being treated and documented medical necessity. Typical sites of service are outpatient hospital infusion centers, physician office infusion suites, or specialty oncology clinics staffed by providers with taxonomies such as Hematology & Oncology or Medical Oncology.

    Related CPT Codes

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    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.,…
    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…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    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
    207ZC0008X
    2084B0040X
    1710I1002X
    207XS0106X
    208U00000X

    Related Codes

    HCPCS-J9000-DOXORUBICIN-10MG-INJECTION

    HCPCS J9000: Doxorubicin Hydrochloride Injection, 10 mg

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

    HCPCS Level II J9003: Leuprolide injectable (camcevi etm), 1 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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    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    CPT CodeDescriptionRelationship to This Procedure
    J9302Injection, ofatumumab, 10 mgListed related HCPCS-level therapeutic monoclonal antibody; used for payer cross-reference when evaluating monoclonal antibody administration policies