Pemfexy J Code: J9304

Drug & Product Overview

HCPCS Descriptor Injection, pemetrexed (pemfexy), 10 mg

HCPCS Added Date October 1, 2020

Manufacturer Acacia Pharma

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Multi-Dose

Dosage Form Injection

About Pemfexy

Pemfexy is a medication aligned to the HCPCS J Code: J9304 for billing, pricing, and reimbursement purposes in the United States. It is an Oncology drug administered via the intravenous route and manufactured by Acacia Pharma.

According to CMS Drug Use Information: Pemetrexed is used to treat certain types of cancer (such as lung cancer, mesothelioma). 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

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

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
42367-0531-33	Pemfexy	Eagle Pharmaceuticals, Inc.	50	500 MG / 20 ML
71390-0250-02	Pemfexy	Acacia Pharma, Ltd.	50	500 MG / 20 ML

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Pemfexy Pricing & Reimbursement

J9304 Private Payer Reimbursement

$43.34 / 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

Pemetrexed 505(b)(2) Information:

HCPCS Code	Manufacturer	Active Ingredient	HCPCS Description
J9292	Avyxa Pharma	Pemetrexed	Injection, pemetrexed dipotassium, 10 mg
J9294	Hospira	Pemetrexed	Injection, pemetrexed (hospira), not therapeutically equivalent to j9305, 10 mg
J9296	Accord	Pemetrexed	Injection, pemetrexed (accord), not therapeutically equivalent to j9305, 10 mg
J9297	Sandoz	Pemetrexed	Injection, pemetrexed (sandoz), not therapeutically equivalent to j9305, 10 mg
J9304	Generic Code (Multiple Manufacturers)	Pemetrexed	Injection, pemetrexed (pemfexy), 10 mg
J9305 Log in to view
J9314 Log in to view
J9322 Log in to view
J9323 Log in to view
J9324 Log in to view

Log in to view all 10 505(b)(2) codes

Pemfexy Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 16.1%

Avg. Days to File 10.8days

Avg. Days to Pay 31.5days

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

Explore J9304 claims analytics on FocalPoint →

Pemfexy 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 Pemfexy (J9304) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J9304. Wastage billing guide →

Pemfexy Medically Unlikely Edits (MUE)

The most billing units of J9304 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg.

Practitioner Office & Hospital Outpatient

150 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 →

Pemfexy 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 Pleural Mesothelioma Non-squamous Non-Small Cell Lung Cancer

Drug Class

Folate Analog Metabolic Inhibitor [EPC]Folic Acid Metabolism Inhibitors [MoA]

Frequently Asked Questions

Is there an available Pemfexy billing and coding guide?

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

Are there any available Pemfexy patient assistance programs?

Pemfexy patient assistance information can be found through Eagle Pharmaceuticals. Visit Here →

Where can I find Pemfexy prescribing information?

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

Where can I find Pemfexy side effect information?

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

Does billing Pemfexy require JZ/JW wastage modifiers?

CMS does not include Pemfexy (J9304) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J9304. For more information, visit the link below.

About BuyandBill.com:

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