HCPCS drug code · CMS crosswalk
Pemfexy J-Code / HCPCS Code
In short
Pemfexy is billed under HCPCS J9304 — Injection, pemetrexed (pemfexy), 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 2 Pemfexy NDCs under this code.
Reference
- J9304
- Injection, pemetrexed (pemfexy), 10 mgBilling unit: 10 mg
- Labelers
- Acacia Pharma Ltd; Eagle Pharmaceuticals, Inc.
Medicare Part B payment limit
CMS ASP filePayment limit per unit$92.505
Per10 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
Pemfexy units and claim line
Enter the dose given to get the J9304 units and the NDC line for the CMS-1500 and the 837P.
Enter the dose given to build the claim line.
Pemfexy 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 |
|---|---|---|---|---|
| 42367-0531-33 | J9304 | Eagle Pharmaceuticals, Inc. | 20 | 50 |
| 71390-0250-02 | J9304 | Acacia Pharma Ltd | 20 | 50 |
Pemfexy: common questions
- What is the J-code for Pemfexy?
- Pemfexy is billed under HCPCS J9304 — Injection, pemetrexed (pemfexy), 10 mg. One billing unit is 10 mg. CMS's crosswalk lists 2 Pemfexy NDCs under this code.
- How many J9304 billing units are in a package of Pemfexy?
- CMS lists 50 billing units per package, depending on the NDC, where one unit is 10 mg. Units to report are based on the dose given, not the package.
- Is J9304 a CPT code?
- No. J9304 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.
Other codes for the same drug
- J9292Injection, pemetrexed dipotassium, 10 mg
- J9294Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg
- J9296Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg
- J9297Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg
- J9305Injection, pemetrexed, not otherwise specified, 10 mg
- J9314Injection, pemetrexed (teva), not therapeutically equivalent to j9305, 10 mg
- J9322Injection, pemetrexed (bluepoint), not therapeutically equivalent to j9305, 10 mg
- J9323Injection, pemetrexed ditromethamine, 10 mg
- J9324Injection, pemetrexed (pemrydi rtu), 10 mg