ARSENIC TRIOXIDE J Code: J9017

Drug & Product Overview

HCPCS Descriptor Injection, arsenic trioxide, 1 mg

HCPCS Added Date January 1, 2002

Manufacturer Multiple Manufacturers

Route of Administration Intravenous

Generic Status Multi-Source; Generic

Dosage Type Single-Dose

Dosage Form Injection | Injection, Solution | Not Available

About ARSENIC TRIOXIDE

Arsenic Trioxide is a medication aligned to the HCPCS J Code: J9017 for billing, pricing, and reimbursement purposes in the United States. Classified under Oncology, it is administered via the intravenous route and manufactured by multiple companies.

According to CMS Drug Use Information: Arsenic trioxide is used to treat a type of leukemia (acute promyelocytic leukemia-APL).

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 5 of 34 NDCs — log in for the full crosswalk.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
00781-3498-94	Arsenic Trioxide	Sandoz Inc	12	12 MG / 6 ML
14789-0600-10	Arsenic Trioxide	Nexus Pharmaceuticals LLC	100	10 MG / 10 ML
23155-0869-41	Arsenic Trioxide	Heritage Pharma Labs Inc. d/b/a Avet Pharmaceuticals Inc	100	10 MG / 10 ML
25021-0226-10	Arsenic Trioxide	Sagent Pharmaceuticals	100	10 MG / 10 ML
50742-0438-10	Arsenic Trioxide	Ingenus Pharmaceuticals, LLC	10	10 MG / 10 ML
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ARSENIC TRIOXIDE Pricing & Reimbursement

J9017 Private Payer Reimbursement

$7.71 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

ARSENIC TRIOXIDE Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 8.89%

Avg. Days to File 7.8days

Avg. Days to Pay 20.1days

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

Explore J9017 claims analytics on FocalPoint →

ARSENIC TRIOXIDE 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 Arsenic Trioxide (J9017) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ARSENIC TRIOXIDE Medically Unlikely Edits (MUE)

The most billing units of J9017 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

30 units / day

= 30 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 →

ARSENIC TRIOXIDE 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.

Acute Promyelocytic Leukemia (APL) Newly-Diagnosed Low-Risk Acute Promyelocytic Leukemia (APL) Relapsed or Refractory APL Relapsed or Refractory Acute Promyelocytic Leukemia (APL)

Frequently Asked Questions

Is there an available Arsenic Trioxide billing and coding guide?

Our team has not identified a manufacturer-published source of billing and coding information for ARSENIC TRIOXIDE.

Are there any available Arsenic Trioxide patient assistance programs?

Our team has not identified a manufacturer-published source of patient assistance information for ARSENIC TRIOXIDE.

Where can I find Arsenic Trioxide prescribing information?

ARSENIC TRIOXIDE prescribing information can be found at the link below. Please reach out to us if you believe this information to be innacurate or out of date. Visit Here →

Where can I find Arsenic Trioxide side effect information?

Our team has not yet identified a source of side effects information for ARSENIC TRIOXIDE. Please check back in a few weeks.

Does billing ARSENIC TRIOXIDE require JZ/JW wastage modifiers?

CMS has identified ARSENIC TRIOXIDE(J9017) 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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