NIPENT J Code: J9268

Drug & Product Overview

HCPCS Descriptor Injection, pentostatin, 10 mg

HCPCS Added Date January 1, 1994

Manufacturer Pfizer

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Powder, Lyophilized, For Solution

About NIPENT

Nipent is a medication aligned to the HCPCS J Code: J9268 for billing, pricing, and reimbursement purposes in the United States. It is an Oncology drug administered via the intravenous route and manufactured by Pfizer.

According to CMS Drug Use Information: Pentostatin is used to treat a certain type of cancer (hairy cell leukemia). 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
00409-0801-01	Nipent	Hospira, Inc.	1	10 MG / 5 ML

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NIPENT Pricing & Reimbursement

J9268 Private Payer Reimbursement

$2,653.63 / 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 Q4 2026

NIPENT 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 Nipent (J9268) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

NIPENT Medically Unlikely Edits (MUE)

The most billing units of J9268 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg.

Practitioner Office & Hospital Outpatient

1 unit / day

= 10 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 →

NIPENT 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.

Hairy Cell Leukemia

Drug Class

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

Frequently Asked Questions

Is there an available Nipent billing and coding guide?

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

Are there any available Nipent patient assistance programs?

NIPENT patient assistance information can be found through Pfizer. Visit Here →

Where can I find Nipent prescribing information?

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

Where can I find Nipent side effect information?

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

Does billing NIPENT require JZ/JW wastage modifiers?

CMS has identified NIPENT(J9268) 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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