GEMCITABINE J Code: J9196

Drug & Product Overview

HCPCS Descriptor Injection, gemcitabine hydrochloride (accord), not therapeutically equivalent to j9201, 200 mg

HCPCS Added Date April 1, 2023

Manufacturer Accord

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Multi-Dose

Dosage Form Injection, Solution

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
	GEMCITABINE
	GEMCITABINE
	GEMCITABINE

Login to view 4 NDC packages View pricing, complete NDC-to-HCPCS alignments, and package details.

Login →

GEMCITABINE Pricing & Reimbursement

J9196 Private Payer Reimbursement

$5.49 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

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

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)

Not on the CMS JW / JZ list

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.

Practitioner Office & Hospital Outpatient

19 units / day

= 3,800 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 →

GEMCITABINE 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.

Breast Cancer Non-Small Cell Lung Cancer Ovarian Cancer Pancreatic Cancer

Drug Class

Nucleic Acid Synthesis Inhibitors [MoA]Nucleoside Metabolic Inhibitor [EPC]

Frequently Asked Questions

Is there an available Gemcitabine billing and coding guide?

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

Are there any available Gemcitabine patient assistance programs?

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

Where can I find Gemcitabine prescribing information?

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

Where can I find Gemcitabine side effect information?

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

Does billing GEMCITABINE require JZ/JW wastage modifiers?

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. For more information, visit the link below.

About BuyandBill.com:

The BuyandBill.com team is dedicated to delivering high-quality coding and billing information for office-administered drugs. We continuously research HCPCS-coded medications to expand our resources and ensure data accuracy. Manufacturers: click here to sponsor your medication, and we will ensure the most accurate and detailed information is displayed.