HCPCS drug code · CMS crosswalk
Fulvestrant J-Code / HCPCS Code
In short
Fulvestrant is billed under HCPCS J9395 — Injection, fulvestrant, 25 mg. One billing unit is 25 mg. CMS's crosswalk lists 21 Fulvestrant NDCs under this code.
Reference
- J9395
- Injection, fulvestrant, 25 mgBilling unit: 25 mg
- Labelers
- Accord Healthcare Inc; Alembic Pharmaceuticals Inc.; Amneal Pharmaceuticals, LLC; Athenex Pharmaceutical Division, LLC; Avenacy Inc.; BluePoint Laboratories; Dr. Reddy's Laboratories Inc.; Eugia US LLCand 8 more
Medicare Part B payment limit
CMS ASP filePayment limit per unit$5.021
Per25 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
Fulvestrant units and claim line
Enter the dose given to get the J9395 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Fulvestrant 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 |
|---|---|---|---|---|
| 00143-9022-02 | J9395 | Hikma Pharmaceuticals USA Inc. | 2 × 5 | 20 |
| 00781-3532-12 | J9395 | Sandoz Inc. | 2 × 5 | 20 |
| 00781-9055-12 | J9395 | Sandoz Inc. | 2 × 5 | 20 |
| 16714-0070-02 | J9395 | Northstar RxLLC | 2 × 5 | 20 |
| 16729-0436-30 | J9395 | Accord Healthcare Inc | 2 × 5 | 20 |
| 25021-0462-74 | J9395 | Sagent Pharmaceuticals | 2 × 5 | 20 |
| 25021-0471-74 | J9395 | Sagent Pharmaceuticals | 2 × 5 | 20 |
| 43598-0262-02 | J9395 | Dr. Reddy's Laboratories Inc. | 2 × 5 | 20 |
| 43598-0262-23 | J9395 | Dr. Reddy's Laboratories Inc. | 2 × 5 | 20 |
| 55150-0394-02 | J9395 | Eugia US LLC | 2 × 5 | 20 |
| 62332-0650-10 | J9395 | Alembic Pharmaceuticals Inc. | 2 × 5 | 20 |
| 63323-0715-05 | J9395 | FreseniUS Kabi USA, LLC | 2 × 5 | 20 |
| 68001-0484-85 | J9395 | BluePoint Laboratories | 2 × 5 | 20 |
| 68001-0522-85 | J9395 | BluePoint Laboratories | 2 × 5 | 20 |
| 68001-0626-85 | J9395 | BluePoint Laboratories | 2 × 5 | 20 |
| 70121-1463-02 | J9395 | Amneal Pharmaceuticals, LLC | 2 × 5 | 20 |
| 70700-0284-98 | J9395 | Xiromed, LLC | 2 × 5 | 20 |
| 70710-1688-08 | J9395 | Zydus Pharmaceuticals (USA) Inc. | 2 × 5 | 20 |
| 70860-0211-74 | J9395 | Athenex Pharmaceutical Division, LLC | 2 × 5 | 20 |
| 71288-0555-86 | J9395 | Meitheal Pharmaceuticals Inc. | 2 × 5 | 20 |
| 83634-0203-74 | J9395 | Avenacy Inc. | 2 × 5 | 20 |
Fulvestrant: common questions
- What is the J-code for Fulvestrant?
- Fulvestrant is billed under HCPCS J9395 — Injection, fulvestrant, 25 mg. One billing unit is 25 mg. CMS's crosswalk lists 21 Fulvestrant NDCs under this code.
- How many J9395 billing units are in a package of Fulvestrant?
- CMS lists 20 billing units per package, depending on the NDC, where one unit is 25 mg. Units to report are based on the dose given, not the package.
- Is J9395 a CPT code?
- No. J9395 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.