POTELIGEO J Code: J9204

Drug & Product Overview

HCPCS Descriptor Injection, mogamulizumab-kpkc, 1 mg

HCPCS Added Date October 1, 2019

Manufacturer Kyowa Kirin

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection

About POTELIGEO

Poteligeo is a medication aligned to the HCPCS J Code: J9204 for billing, pricing, and reimbursement purposes in the United States. This Oncology medication is administered via the intravenous route and manufactured by Kyowa Kirin.

According to CMS Drug Use Information: This medication is used to treat certain cancers (such as mycosis fungoides, Sezary syndrome). Mogamulizumab belongs to a class of drugs known as monoclonal antibodies. It works by changing the action of your own immune system, directing it to attack cancer cells. This effect helps slow or stop 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
42747-0761-01	Poteligeo	Kyowa Kirin, Inc.	20	20 MG / 5 ML

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POTELIGEO Pricing & Reimbursement

J9204 Private Payer Reimbursement

$261.63 / 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 Q3 2026

POTELIGEO 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 Poteligeo (J9204) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

POTELIGEO Medically Unlikely Edits (MUE)

The most billing units of J9204 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

160 units / day

= 160 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 →

POTELIGEO 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.

mycosis fungoides (MF) or Sézary syndrome (SS)

Drug Class

AntibodiesMonoclonal [CS]Chemokine Receptor Type 4 Interaction [EPC]Chemokine Receptor Type 4 Interactions [MoA]Monoclonal Antibody [EPC]

Frequently Asked Questions

Is there an available Poteligeo billing and coding guide?

Billing and coding information for POTELIGEO can be found through Kyowa Kirin. Visit Here →

Are there any available Poteligeo patient assistance programs?

POTELIGEO patient assistance information can be found through Kyowa Kirin. Visit Here →

Where can I find Poteligeo prescribing information?

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

Where can I find Poteligeo side effect information?

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

Does billing POTELIGEO require JZ/JW wastage modifiers?

CMS has identified POTELIGEO(J9204) 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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