HCPCS J9155: Degarelix Injection, 1 mg

HCPCS Level II code J9155 denotes a 1 mg injection of degarelix, an injectable gonadotropin-releasing hormone antagonist used in androgen deprivation therapy for prostate cancer. As a drug-specific HCPCS Level II code, J9155 is used on medical claims to identify administered degarelix units and to support clinical and financial tracking of oncology drug use across outpatient settings. Nationally, accurate coding for injectable oncology agents affects provider reimbursement, eligibility for pharmacy vs. medical benefit coverage, and program integrity oversight.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for degarelix, typical sites of service where the injection is administered, and the role of J9155 in claims processing. The publication also summarizes benchmarking elements and policy considerations commonly associated with HCPCS drug codes, such as unit reporting, billing practice implications, and payer coverage dynamics. Data not available in the input is noted where applicable.

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Billing Code Overview

HCPCS Level II code J9155 represents an injection of degarelix, 1 mg. This code describes the drug administration of degarelix, a gonadotropin-releasing hormone (GnRH) antagonist used in oncology for androgen deprivation therapy.

Service type: Drug administration (injectable oncology medication)
Typical site of service: Administration commonly occurs in outpatient oncology clinics, physician offices, and hospital outpatient departments where injectable cancer therapies are provided.

Data not available in the input.

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HCPCS J9155: Degarelix Injection, 1 mg

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Get alerted when payer policies referencing J9155 are released or updated.

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Billing Code Overview

Service type: Drug administration (injectable oncology medication)
Typical site of service: Administration commonly occurs in outpatient oncology clinics, physician offices, and hospital outpatient departments where injectable cancer therapies are provided.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult male diagnosed with advanced prostate cancer requiring androgen deprivation therapy. The patient presents to an outpatient oncology or urology clinic for administration of J9155 (degarelix) as a monthly subcutaneous injection. The clinical workflow includes verification of the indication and recent testosterone and PSA levels, informed consent, assessment for prior hypersensitivity to gonadotropin-releasing hormone (GnRH) antagonists, medication reconciliation, and documentation of baseline vital signs. The nurse prepares the pre-filled syringe of degarelix, applies aseptic technique, and administers the subcutaneous injection to the abdominal or thigh area. Observation for immediate injection-site reaction or systemic adverse effects (e.g., hot flashes, injection-site erythema, allergic reaction) follows for a short period before discharge. Scheduled follow-up visits include monitoring of PSA and testosterone suppression, management of side effects, and coordination of subsequent monthly injections or switch to alternative androgen deprivation therapy if clinically indicated.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C61`	Malignant neoplasm of prostate	Primary indication for degarelix as androgen deprivation therapy in advanced or metastatic prostate cancer.
`Z85.46`	Personal history of malignant neoplasm of prostate	Relevant for ongoing hormone therapy management in patients with prior prostate cancer.
`N40`	Benign prostatic hyperplasia	Distinguish from malignant indications; degarelix is not indicated for simple BPH but documentation should clarify diagnosis.
`E23.0`	Hypopituitarism	Endocrine disorders can affect management of GnRH antagonist therapy and require clinical consideration.
`T78.2`	Anaphylactic shock, unspecified	Important to document and consider if prior severe allergic reaction to injectable agents; affects eligibility for repeat administration.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance) subcutaneous or intramuscular	Common code used for billing the professional administration of a subcutaneous medication such as `J9155` in an outpatient setting.
`96401`	Chemotherapy administration, subcutaneous or intramuscular; non-hormonal antineoplastic	Occasionally used in some payer contexts for oncology injections; verify payer policy for hormone antagonist injections.
`81002`	Urinalysis, by dipstick or tablet reagent for non-automated, without microscopy	Used as a point-of-care test if ordered during the visit for baseline monitoring or infection screening.
`83001`	Hemoglobin; glycosylated (HbA1c) point-of-care testing	May be performed if metabolic monitoring is required during oncology follow-up visits.
`84403`	Prostate specific antigen (PSA)	Laboratory monitoring commonly ordered before or during androgen deprivation therapy to assess response.
`84402`	Testosterone; total	Laboratory test used to confirm castrate levels after initiation of `J9155` therapy.

Related Modifiers

9 rows

Modifier	Description	When to Use
22	Unusual procedural services	Use when the service requires substantially greater work than usual (extensive documentation required).
23	Unusual anesthesia	Rare for `J9155` but used if qualifying anesthesia unrelated to the drug administration is required.
52	Reduced services	Use when the administration is partially reduced or discontinued (e.g., dose not fully administered).
53	Discontinued procedure	Use if the injection was attempted but discontinued due to unforeseen clinical circumstances.
56	Preoperative management only	Use if only pre-procedure evaluation is performed and injection not administered (limited applicability).
62	Two surgeons	Use if two physicians of different specialties are required for the administration event (rare).
78	Unplanned return to OR	Not typically applicable; include only when a return to procedure suite occurs for complication related to administration.
80	Assistant surgeon	Use when a surgical assistant is legitimately assisting with a procedure related to therapy delivery (rare for this injection).
82	Assistant surgeon (qualified resident)	Use when a qualified resident acts as assistant under payer rules (rare for outpatient injection).

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology-Oncology	Medical oncologists frequently manage androgen deprivation therapy and supervise `J9155` administration.
2084P0800X	Urology	Urologists commonly initiate and manage prostate cancer hormone therapy and coordinate injections.
363A00000X	Registered Nurse	Nurses perform preparation, subcutaneous administration, and patient monitoring in outpatient clinics.
207K00000X	Medical Oncology	Oncology specialists involved in systemic therapy planning and follow-up monitoring.
363AM0700X	Medical Physician Assistant	Physician Assistants & Advanced Practice Nursing Providers · Physician Assistant
1710I1003X	Independent Duty Medical Technicians	An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatmen…
273100000X	Epilepsy Hospital Unit	An Epilepsy Unit is a distinct unit of a hospital that provides services that may include observation, urgent care, diagnostic testing, treatment, and…
363LN0000X	Neonatal Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner

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-J9010-ALEMTUZUMAB-INJECTION-10MG

HCPCS J9010: Injection, Alemtuzumab 10 mg

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

HCPCS Level II J9011: Injection, datopotamab deruxtecan-dlnk, 1 mg

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

HCPCS J9015: Aldesleukin Injection, Single-Use Vial

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

HCPCS J9017: Injection, Arsenic Trioxide, 1 mg

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

HCPCS J9019: Asparaginase (erwinaze) Injection, 1,000 IU

HCPCS-J9020-ASPARAGINASE-INJECTION-10000-UNITS

HCPCS J9020: Injection, Asparaginase, 10,000 Units

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

HCPCS J9021: Injection, Asparaginase (Rylaze), 0.1 mg

HCPCS-J9022-ATEZOLIZUMAB-INJECTION-10MG

HCPCS J9022: Atezolizumab Injection, 10 mg

Showing 1–10 of 227

References

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.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.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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Clinical & Coding Specifications

Clinical Context

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`C61`	Malignant neoplasm of prostate	Primary indication for degarelix as androgen deprivation therapy in advanced or metastatic prostate cancer.
`Z85.46`	Personal history of malignant neoplasm of prostate	Relevant for ongoing hormone therapy management in patients with prior prostate cancer.
`N40`	Benign prostatic hyperplasia	Distinguish from malignant indications; degarelix is not indicated for simple BPH but documentation should clarify diagnosis.
`E23.0`	Hypopituitarism	Endocrine disorders can affect management of GnRH antagonist therapy and require clinical consideration.
`T78.2`	Anaphylactic shock, unspecified	Important to document and consider if prior severe allergic reaction to injectable agents; affects eligibility for repeat administration.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance) subcutaneous or intramuscular	Common code used for billing the professional administration of a subcutaneous medication such as `J9155` in an outpatient setting.
`96401`	Chemotherapy administration, subcutaneous or intramuscular; non-hormonal antineoplastic	Occasionally used in some payer contexts for oncology injections; verify payer policy for hormone antagonist injections.
`81002`	Urinalysis, by dipstick or tablet reagent for non-automated, without microscopy	Used as a point-of-care test if ordered during the visit for baseline monitoring or infection screening.
`83001`	Hemoglobin; glycosylated (HbA1c) point-of-care testing	May be performed if metabolic monitoring is required during oncology follow-up visits.
`84403`	Prostate specific antigen (PSA)	Laboratory monitoring commonly ordered before or during androgen deprivation therapy to assess response.
`84402`	Testosterone; total	Laboratory test used to confirm castrate levels after initiation of `J9155` therapy.

Related Modifiers

9 rows

Modifier	Description	When to Use
22	Unusual procedural services	Use when the service requires substantially greater work than usual (extensive documentation required).
23	Unusual anesthesia	Rare for `J9155` but used if qualifying anesthesia unrelated to the drug administration is required.
52	Reduced services	Use when the administration is partially reduced or discontinued (e.g., dose not fully administered).
53	Discontinued procedure	Use if the injection was attempted but discontinued due to unforeseen clinical circumstances.
56	Preoperative management only	Use if only pre-procedure evaluation is performed and injection not administered (limited applicability).
62	Two surgeons	Use if two physicians of different specialties are required for the administration event (rare).
78	Unplanned return to OR	Not typically applicable; include only when a return to procedure suite occurs for complication related to administration.
80	Assistant surgeon	Use when a surgical assistant is legitimately assisting with a procedure related to therapy delivery (rare for this injection).
82	Assistant surgeon (qualified resident)	Use when a qualified resident acts as assistant under payer rules (rare for outpatient injection).

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207RH0000X	Hematology-Oncology	Medical oncologists frequently manage androgen deprivation therapy and supervise `J9155` administration.
2084P0800X	Urology	Urologists commonly initiate and manage prostate cancer hormone therapy and coordinate injections.
363A00000X	Registered Nurse	Nurses perform preparation, subcutaneous administration, and patient monitoring in outpatient clinics.
207K00000X	Medical Oncology	Oncology specialists involved in systemic therapy planning and follow-up monitoring.
363AM0700X	Medical Physician Assistant	Physician Assistants & Advanced Practice Nursing Providers · Physician Assistant
1710I1003X	Independent Duty Medical Technicians	An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatmen…
273100000X	Epilepsy Hospital Unit	An Epilepsy Unit is a distinct unit of a hospital that provides services that may include observation, urgent care, diagnostic testing, treatment, and…
363LN0000X	Neonatal Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner

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-J9010-ALEMTUZUMAB-INJECTION-10MG

HCPCS J9010: Injection, Alemtuzumab 10 mg

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

HCPCS Level II J9011: Injection, datopotamab deruxtecan-dlnk, 1 mg

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

HCPCS J9015: Aldesleukin Injection, Single-Use Vial

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

HCPCS J9017: Injection, Arsenic Trioxide, 1 mg

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

HCPCS J9019: Asparaginase (erwinaze) Injection, 1,000 IU

HCPCS-J9020-ASPARAGINASE-INJECTION-10000-UNITS

HCPCS J9020: Injection, Asparaginase, 10,000 Units

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

HCPCS J9021: Injection, Asparaginase (Rylaze), 0.1 mg

HCPCS-J9022-ATEZOLIZUMAB-INJECTION-10MG

HCPCS J9022: Atezolizumab Injection, 10 mg

Showing 1–10 of 227

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.