JELMYTO J Code: J9281

Drug & Product Overview

HCPCS Descriptor Mitomycin pyelocalyceal instillation, 1 mg

HCPCS Added Date January 1, 2021

Manufacturer Urogen

Route of Administration Instillation

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Kit

About JELMYTO

Jelmyto is a medication aligned to the HCPCS J Code: J9281 for billing, pricing, and reimbursement purposes in the United States. Classified under Oncology, it is administered via the instillation route and manufactured by Urogen.

According to CMS Drug Use Information: Mitomycin is used to treat cancer in the lining of the urinary tract and kidneys. It 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

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
72493-0103-03	Jelmyto	UroGen Pharma, Inc.	80	Kit

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JELMYTO Pricing & Reimbursement

J9281 Private Payer Reimbursement

$334.51 / 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

Mitomycin 505(b)(2) Information:

HCPCS Code	Manufacturer	Active Ingredient	HCPCS Description
J9281	UroGen Pharma	Mitomycin	Mitomycin pyelocalyceal instillation, 1 mg
J9282	UroGen Pharma	Mitomycin	Mitomycin, intravesical instillation, 1 mg

JELMYTO Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 0%

Avg. Days to File 23.8days

Avg. Days to Pay 0.0days

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

Explore J9281 claims analytics on FocalPoint →

JELMYTO CPT Administration Codes

CPT Code	Description
51720	Bladder instillation of anticarcinogenic agent, including retention time

JW / JZ modifiers apply

CMS has identified Jelmyto (J9281) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

JELMYTO Medically Unlikely Edits (MUE)

The most billing units of J9281 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

80 units / day

= 80 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 →

JELMYTO 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.

Low-grade Upper Tract Urothelial Cancer (LG-UTUC)

Frequently Asked Questions

Is there an available Jelmyto billing and coding guide?

Billing and coding information for JELMYTO can be found through Urogen. Visit Here →

Are there any available Jelmyto patient assistance programs?

JELMYTO patient assistance information can be found through Urogen. Visit Here →

Where can I find Jelmyto prescribing information?

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

Where can I find Jelmyto side effect information?

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

Does billing JELMYTO require JZ/JW wastage modifiers?

CMS has identified JELMYTO(J9281) 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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