HCPCS Code Details - J9055

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J9055
Description

Long description:
Injection, cetuximab, 10 mg

Short description:
Cetuximab injection

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code C - Carrier judgment
ASC payment group code Effective Jan 01, 2008 - This procedure is approved to be performed in an ambulatory surgical center.
BETOS2 code O1E - Other drugs
HCPCS Action code N - No maintenance for this code
Type of service 1 - Medical care
Effective date Effective Jan 01, 2005
Date added Added Jan 01, 2005
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - J9055

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
10 MG 73.487 - - - - - -
January 1, 2024 - March 31, 2024 10 MG 73.72 - - - - - -
October 1, 2023 - December 31, 2023 10 MG 72.276 20% - - - - -
Jul 1, 2023 - Sep 30, 2023 10 MG 72.078 20% - - - - -
April 1, 2023 - June 30, 2023 10 MG 70.142 20% - - - - -

See also

  • HCPCS J9052 · Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg

  • HCPCS J9056 · Injection, bendamustine hydrochloride (vivimusta), 1 mg


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”