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Updated July 1st, 2026

AKYNZEO J Code: J1454

Injection, fosnetupitant 235 mg and palonosetron 0.25 mg

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Q4 2026 Medicare Payment Limit for J1454, effective October 1, 2026: $479.902 per HCPCS billing unit, down 4.8% from $503.848. From CMS's final file.

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Medicare Payment Limit ?
$503.848
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$503.848
/ HCPCS billing unit · APC 9099
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
3
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Drug & Product Overview

HCPCS Descriptor Injection, fosnetupitant 235 mg and palonosetron 0.25 mg
HCPCS Added Date January 1, 2019
Manufacturer Helsinn Therapeutics US
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection

About AKYNZEO

Akynzeo is a medication aligned to the HCPCS J Code: J1454 for billing, pricing, and reimbursement purposes in the United States. Classified under Anti-Emetic, it is administered via the intravenous route and manufactured by Helsinn Therapeutics US.

According to CMS Drug Use Information: This product is a combination of 2 medications: fosnetupitant and palonosetron. It is used to prevent nausea and vomiting caused by cancer drug treatment (chemotherapy). Fosnetupitant and palonosetron work by blocking natural substances in the body (such as substance P/neurokinin 1, serotonin) that cause vomiting.

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. Showing 2 of 3 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
69639-0105-01 Akynzeo Helsinn Therapeutics (U.S.), Inc. 1 260 MG / 20 ML
69639-0106-01 Akynzeo Helsinn Therapeutics (U.S.), Inc. 1 260 MG / 20 ML
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AKYNZEO Pricing & Reimbursement

J1454 Private Payer Reimbursement
$574.75 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

AKYNZEO CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96375 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); each additional sequential intravenous push of a new substance/drug.
Not on the CMS JW / JZ list

CMS does not include Akynzeo (J1454) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1454. Wastage billing guide →

AKYNZEO Medically Unlikely Edits (MUE)

The most billing units of J1454 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.25 mg.

Practitioner Office & Hospital Outpatient
1 unit / day
= 0.25 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 →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

AKYNZEO 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.

nausea and vomiting associated with anthracycline and cyclophosphamide-based chemotherapy and chemotherapy not considered highly emetogenic nausea and vomiting associated with highly emetogenic cancer chemotherapy, including cisplatin-based chemotherapy
Drug Class
Serotonin 3 Receptor Antagonists [MoA]Serotonin-3 Receptor Antagonist [EPC]

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Frequently Asked Questions

Is there an available Akynzeo billing and coding guide?
Billing and coding information for AKYNZEO can be found through Helsinn Therapeutics. Visit Here →
Are there any available Akynzeo patient assistance programs?
AKYNZEO patient assistance information can be found through Helsinn Therapeutics. Visit Here →
Where can I find Akynzeo prescribing information?
AKYNZEO prescribing information can be found at the link below: Visit Here →
Where can I find Akynzeo side effect information?
Information regarding AKYNZEO's side effects can be found at MedlinePlus Visit Here →
Does billing AKYNZEO require JZ/JW wastage modifiers?
CMS does not include AKYNZEO (J1454) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1454. For more information, visit the link below.

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