In short

J9281 is the HCPCS Level II code for mitomycin pyelocalyceal instillation, 1 mg. CMS assigns NDCs for Jelmyto to it. One billing unit is 1 mg. The Medicare Part B payment limit is $329.071 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ9281
Billing unit1 mg
Descriptor
Mitomycin pyelocalyceal instillation, 1 mg
Short descriptor
Mitomycin instillation
Code set
HCPCS Level II, maintained by CMS
Effective
Jan 1, 2021

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$329.071
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

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 J9281

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 1 NDC to J9281 for Jelmyto. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J9281 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Jelmyto72493-0103-03UroGen Pharma2 × 180

J9281: common questions

Is J9281 a CPT code?
No. J9281 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 J9281?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 1 NDC under J9281, for Jelmyto. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J9281?
$329.071 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 J9281?
One unit of J9281 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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