GEMCITABINE J Code: J9196
Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg
Drug & Product Overview
About GEMCITABINE
Gemcitabine is a medication aligned to the HCPCS J Code: J9196 for billing, pricing, and reimbursement purposes in the United States. It is an Oncology drug administered via the intravenous route and manufactured by Accord.
According to CMS Drug Use Information: Gemcitabine is used to treat certain types of cancer (including biliary tract, breast, lung, ovarian, pancreatic). It is a chemotherapy drug that 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
4 NDC packages are crosswalked to J9196. Package detail is available to logged-in subscribers.
| NDC Code | Drug | Manufacturer | Billing Units / Pkg | Package Size |
|---|---|---|---|---|
| •••••-••••-•• Log in to view | GEMCITABINE | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | GEMCITABINE | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | GEMCITABINE | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | GEMCITABINE | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
GEMCITABINE Pricing & Reimbursement
National median reimbursement across major commercial payers.
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Gemcitabine 505(b)(2) Information:
| HCPCS Code | Manufacturer | Active Ingredient | HCPCS Description |
|---|---|---|---|
| J9184 | Avyxa Pharma | Gemcitabine | Injection, gemcitabine hydrochloride (avyxa), 200 mg |
| J9196 | Accord | Gemcitabine | Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg |
| J9198 | Sun Pharma | Gemcitabine | Injection, gemcitabine hydrochloride, (infugem), 100 mg |
| J9201 | Generic Code (Multiple Manufacturers) | Gemcitabine | Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
GEMCITABINE 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 |
|---|---|
| 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) |
CMS does not include Gemcitabine (J9196) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J9196. Wastage billing guide →
GEMCITABINE Medically Unlikely Edits (MUE)
The most billing units of J9196 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 200 mg.
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 →
GEMCITABINE Clinical Information
Indications and drug classification.
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.
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Compare GEMCITABINE with same-ingredient drugs
- GEMCITABINE J9196
- AVGEMSI J9184
- GEMCITABINE J9201
ASP, the Medicare payment limit, WAC and AWP for all 3 drugs on one timeline, with 10+ years of monthly history.
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Frequently Asked Questions
Is there an available Gemcitabine billing and coding guide?
Are there any available Gemcitabine patient assistance programs?
Where can I find Gemcitabine prescribing information?
Where can I find Gemcitabine side effect information?
Does billing GEMCITABINE require JZ/JW wastage modifiers?
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