Home › Drug Codes › J Codes › J1627 · SUSTOL
Updated July 1st, 2026

SUSTOL J Code: J1627

Injection, granisetron, extended-release, 0.1 mg

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Q4 2026 Medicare Payment Limit for J1627, effective October 1, 2026: $2.907 per HCPCS billing unit, down 9.6% from $3.217. From CMS's final file.

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Medicare Payment Limit ?
$3.217
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$3.217
/ HCPCS billing unit · APC 9421
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
1
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Drug & Product Overview

HCPCS Descriptor Injection, granisetron, extended-release, 0.1 mg
HCPCS Added Date January 1, 2018
Manufacturer Heron Therapeutics
Route of Administration Subcutaneous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection

About SUSTOL

Sustol is a medication aligned to the HCPCS J Code: J1627 for billing, pricing, and reimbursement purposes in the United States. It is an Anti-Emetic drug administered via the subcutaneous route and manufactured by Heron Therapeutics.

According to CMS Drug Use Information: Granisetron is used to help prevent nausea and vomiting caused by cancer chemotherapy. It works by blocking the effect of a natural substance in your body (serotonin) that may cause nausea or vomiting.

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
47426-0101-06 Sustol Heron Therapeutics, Inc. 600 10 MG / 0.4 ML
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SUSTOL Pricing & Reimbursement

J1627 Private Payer Reimbursement
$4.28 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

Granisetron 505(b)(2) Information:

HCPCS Code Manufacturer Active Ingredient HCPCS Description
J1627 Heron Therapeutics Granisetron Injection, granisetron, extended-release, 0.1 mg

SUSTOL Claims Performance

Claims from Jan 2026 – Aug 2026
Claim Denial Rate 9.42%
Avg. Days to File 7.4days
Avg. Days to Pay 22.3days

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

Explore J1627 claims analytics on FocalPoint →
OnPoint Oncology

SUSTOL CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular
96401 Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic
Not on the CMS JW / JZ list

CMS does not include Sustol (J1627) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1627. Wastage billing guide →

SUSTOL Medically Unlikely Edits (MUE)

The most billing units of J1627 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.1 mg.

Practitioner Office & Hospital Outpatient
100 units / 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 →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

SUSTOL 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.

acute and delayed nausea and vomiting associated with anthracycline and cyclophosphamide (AC) combination chemotherapy regimens acute and delayed nausea and vomiting associated with moderately emetogenic chemotherapy (MEC)
Drug Class
Serotonin 3 Receptor Antagonists [MoA]Serotonin-3 Receptor Antagonist [EPC]

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Frequently Asked Questions

Is there an available Sustol billing and coding guide?
Billing and coding information for SUSTOL can be found through Heron Therapeutics. Visit Here →
Are there any available Sustol patient assistance programs?
SUSTOL patient assistance information can be found through Heron Therapeutics. Visit Here →
Where can I find Sustol prescribing information?
SUSTOL prescribing information can be found at the link below: Visit Here →
Where can I find Sustol side effect information?
Information regarding SUSTOL's side effects can be found at MedlinePlus Visit Here →
Does billing SUSTOL require JZ/JW wastage modifiers?
CMS does not include SUSTOL (J1627) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1627. For more information, visit the link below.

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Explore billing, coding, and pricing for drugs related to SUSTOL.

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