In short

J9042 is the HCPCS Level II code for injection, brentuximab vedotin, 1 mg. CMS assigns NDCs for Adcetris to it. One billing unit is 1 mg. The Medicare Part B payment limit is $279.207 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ9042
Billing unit1 mg
Descriptor
Injection, brentuximab vedotin, 1 mg
Short descriptor
Brentuximab vedotin inj
Code set
HCPCS Level II, maintained by CMS
Effective
Jan 1, 2013

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$279.207
Per1 mg
Coinsurance17.251%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: Inflation-adjusted coinsurance. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Units and claim line

Units = dose given ÷ 1 mg. For example, 100 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

NDCs billed under J9042

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 1 NDC to J9042 for Adcetris. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J9042 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Adcetris51144-0050-01Pfizer Inc150

J9042: common questions

Is J9042 a CPT code?
No. J9042 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under J9042?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 1 NDC under J9042, for Adcetris. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J9042?
$279.207 per 1 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.
What is one billing unit of J9042?
One unit of J9042 is 1 mg, as stated in the code's descriptor. Units to report = dose given ÷ 1 mg. J-code billing units.

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