ADCETRIS J Code: J9042

Drug & Product Overview

HCPCS Descriptor Injection, brentuximab vedotin, 1 mg

HCPCS Added Date January 1, 2013

Manufacturer Seagen

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Powder, Lyophilized, For Solution

About ADCETRIS

Adcetris is a medication aligned to the HCPCS J Code: J9042 for billing, pricing, and reimbursement purposes in the United States. This Oncology medication is administered via the intravenous route and manufactured by Seagen.

According to CMS Drug Use Information: Brentuximab is used to treat certain types of cancers (Hodgkin's lymphoma, systemic anaplastic large cell lymphoma, peripheral T-cell lymphoma, primary cutaneous anaplastic large cell lymphoma, mycosis fungoides, large B-cell lymphoma). It works by slowing or stopping the growth of cancer cells.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
51144-0050-01	Adcetris	SEAGEN INC.	50	50 MG / 10.5 ML

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ADCETRIS Pricing & Reimbursement

J9042 Private Payer Reimbursement

$275.94 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

ADCETRIS Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 16.55%

Avg. Days to File 10.8days

Avg. Days to Pay 29.7days

Real-world claims performance from FocalPoint, OnPoint Oncology's reimbursement analytics platform, with claims data accrued at the clearing house level.

Explore J9042 claims analytics on FocalPoint →

ADCETRIS CPT Administration Codes

CPT Code	Description
96413	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415	Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)

JW / JZ modifiers apply

CMS has identified Adcetris (J9042) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ADCETRIS Medically Unlikely Edits (MUE)

The most billing units of J9042 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

200 units / day

= 200 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

ADCETRIS Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Classical Hodgkin Lymphoma Large B-Cell Lymphoma Primary Cutaneous Anaplastic Large Cell Lymphoma or CD30-Expressing Mycosis Fungoides Systemic Anaplastic Large Cell Lymphoma Systemic Anaplastic Large Cell Lymphoma or Other CD30-Expressing Peripheral T-cell Lymphomas

Drug Class

CD30-directed Antibody Interactions [MoA]CD30-directed Immunoconjugate [EPC]Immunoconjugates [CS]Microtubule Inhibition [PE]

Frequently Asked Questions

Is there an available Adcetris billing and coding guide?

Billing and coding information for ADCETRIS can be found through Seattle Genetics. Visit Here →

Are there any available Adcetris patient assistance programs?

ADCETRIS patient assistance information can be found through Seattle Genetics. Visit Here →

Where can I find Adcetris prescribing information?

ADCETRIS prescribing information can be found at the link below: Visit Here →

Where can I find Adcetris side effect information?

Information regarding ADCETRIS's side effects can be found at MedlinePlus Visit Here →

Does billing ADCETRIS require JZ/JW wastage modifiers?

CMS has identified ADCETRIS(J9042) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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