CYCLOPHOSPHAMIDE J Code: J8530

Drug & Product Overview

HCPCS Descriptor Cyclophosphamide; oral, 25 mg

HCPCS Added Date January 1, 1995

Manufacturer Multiple Manufacturers

Route of Administration Oral

Generic Status Multi-Source; Generic

Dosage Form Capsule | Not Available | Tablet

About CYCLOPHOSPHAMIDE

Cyclophosphamide is a medication aligned to the HCPCS J Code: J8530 for billing, pricing, and reimbursement purposes in the United States. It is an Oncology drug administered via the oral route and manufactured by multiple companies.

According to CMS Drug Use Information: Cyclophosphamide is used to treat various types of cancer. It is a chemotherapy drug that works by slowing or stopping cell growth. Cyclophosphamide also works by decreasing your immune system's response to various diseases. It is used to treat a certain type of kidney disease in children after other treatments have not worked.

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 12 NDCs — log in for the full crosswalk.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
00054-0382-25	Cyclophosphamide	Hikma Pharmaceuticals USA Inc.	100	25 MG
00054-0383-25	Cyclophosphamide	Hikma Pharmaceuticals USA Inc.	200	50 MG
10019-0984-01	Cyclophosphamide	Baxter Healthcare Corporation	200	50 MG
69097-0516-07	Cyclophosphamide	Cipla USA Inc.	100	25 MG
69097-0517-07	Cyclophosphamide	Cipla USA Inc.	200	50 MG
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CYCLOPHOSPHAMIDE Pricing & Reimbursement

J8530 Private Payer Reimbursement

$1.62 / 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

CYCLOPHOSPHAMIDE 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)
96409 Login for More	Chemotherapy administration; intravenous, push technique, single or initial substance/drug Login for More

Not on the CMS JW / JZ list

CMS does not include Cyclophosphamide (J8530) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J8530. Wastage billing guide →

CYCLOPHOSPHAMIDE Medically Unlikely Edits (MUE)

The most billing units of J8530 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 25 mg. The limit is different in the office and the hospital. Use the one for your setting.

Practitioner Office

0 units / day

Not payable in this setting

Hospital Outpatient

60 units / day

= 1,500 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 →

CYCLOPHOSPHAMIDE 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.

Malignant Diseases Minimal Change Nephrotic Syndrome

Drug Class

Alkylating Activity [MoA]Alkylating Drug [EPC]

Frequently Asked Questions

Is there an available Cyclophosphamide billing and coding guide?

We have not yet identified a manufacturer source of Cyclophosphamide billing and coding information.

Are there any available Cyclophosphamide patient assistance programs?

Our team did not identify a source for Cyclophosphamide patient assistance information. Please reach out to our team if you feel that this is a mistake.

Where can I find Cyclophosphamide prescribing information?

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

Where can I find Cyclophosphamide side effect information?

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

Does billing CYCLOPHOSPHAMIDE require JZ/JW wastage modifiers?

CMS does not include CYCLOPHOSPHAMIDE (J8530) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J8530. For more information, visit the link below.

About BuyandBill.com:

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