HCPCS drug code · CMS crosswalk
Arsenic Trioxide J-Code / HCPCS Code
In short
Arsenic Trioxide is billed under HCPCS J9017 — Injection, arsenic trioxide, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 21 Arsenic Trioxide NDCs under this code.
Reference
- J9017
- Injection, arsenic trioxide, 1 mgBilling unit: 1 mg
- Labelers
- Amneal Pharmaceuticals, LLC; Athenex Pharmaceutical Division, LLC; FreseniUS Kabi USA, LLC; Heritage Pharmaceuticals Inc.; Ingenus Pharmaceuticals LLC; Nexus Pharmaceuticals, LLC; Nordic Pharma, Inc; Northstar RxLLCand 4 more
Medicare Part B payment limit
CMS ASP filePayment limit per unit$3.837
Per1 mg
Coinsurance20%
Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Arsenic Trioxide units and claim line
Enter the dose given to get the J9017 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Arsenic Trioxide NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 00781-3498-94 | J9017 | Sandoz Inc. | 6 | 12 |
| 00781-3498-95 | J9017 | Sandoz Inc. | 10 × 6 | 120 |
| 14789-0600-10 | J9017 | Nexus Pharmaceuticals, LLC | 10 × 10 | 100 |
| 23155-0869-41 | J9017 | Heritage Pharmaceuticals Inc. | 10 × 10 | 100 |
| 23155-0870-41 | J9017 | Heritage Pharmaceuticals Inc. | 10 × 6 | 120 |
| 25021-0226-10 | J9017 | Sagent Pharmaceuticals | 10 × 10 | 100 |
| 25021-0227-06 | J9017 | Sagent Pharmaceuticals | 10 × 6 | 120 |
| 50742-0438-10 | J9017 | Ingenus Pharmaceuticals LLC | 10 | 10 |
| 63323-0637-10 | J9017 | FreseniUS Kabi USA, LLC | 10 × 10 | 100 |
| 68382-0997-10 | J9017 | Zydus Pharmaceuticals (USA) Inc. | 10 × 10 | 100 |
| 69918-0720-02 | J9017 | Nordic Pharma, Inc | 2 × 10 | 20 |
| 69918-0720-10 | J9017 | Nordic Pharma, Inc | 10 × 10 | 100 |
| 70121-1483-07 | J9017 | Amneal Pharmaceuticals, LLC | 10 × 10 | 100 |
| 70121-1658-01 | J9017 | Amneal Pharmaceuticals, LLC | 10 × 6 | 120 |
| 70710-1610-06 | J9017 | Zydus Pharmaceuticals (USA) Inc. | 10 × 6 | 120 |
| 70710-1895-06 | J9017 | Zydus Pharmaceuticals (USA) Inc. | 10 × 10 | 100 |
| 70710-1896-06 | J9017 | Zydus Pharmaceuticals (USA) Inc. | 10 × 6 | 120 |
| 70860-0217-10 | J9017 | Athenex Pharmaceutical Division, LLC | 10 | 10 |
| 72205-0171-07 | J9017 | Novadoz Pharmaceuticals LLC | 10 × 10 | 100 |
| 72205-0172-07 | J9017 | Novadoz Pharmaceuticals LLC | 10 × 6 | 120 |
| 72603-0339-10 | J9017 | Northstar RxLLC | 10 × 10 | 100 |
Arsenic Trioxide: common questions
- What is the J-code for Arsenic Trioxide?
- Arsenic Trioxide is billed under HCPCS J9017 — Injection, arsenic trioxide, 1 mg. One billing unit is 1 mg. CMS's crosswalk lists 21 Arsenic Trioxide NDCs under this code.
- How many J9017 billing units are in a package of Arsenic Trioxide?
- CMS lists 10 to 120 billing units per package, depending on the NDC, where one unit is 1 mg. Units to report are based on the dose given, not the package.
- Is J9017 a CPT code?
- No. J9017 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.