ZEPZELCA J Code: J9223

Drug & Product Overview

HCPCS Descriptor Injection, lurbinectedin, 0.1 mg

HCPCS Added Date January 1, 2021

Manufacturer Jazz Pharmaceuticals

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Powder, Lyophilized, For Solution

About ZEPZELCA

Zepzelca is a medication aligned to the HCPCS J Code: J9223 for billing, pricing, and reimbursement purposes in the United States. It is an Oncology drug administered via the intravenous route and manufactured by Jazz Pharmaceuticals.

According to CMS Drug Use Information: This medication is used to treat lung cancer. Lurbinectedin belongs to a class of drugs known as alkylating agents. 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
68727-0712-01	Zepzelca	Jazz Pharmaceuticals, Inc.	40	4 MG / 8 ML

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ZEPZELCA Pricing & Reimbursement

J9223 Private Payer Reimbursement

$217.59 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

ZEPZELCA Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 11.49%

Avg. Days to File 7.5days

Avg. Days to Pay 24.3days

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

Explore J9223 claims analytics on FocalPoint →

ZEPZELCA 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 Zepzelca (J9223) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ZEPZELCA Medically Unlikely Edits (MUE)

The most billing units of J9223 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.1 mg.

Practitioner Office & Hospital Outpatient

120 units / day

= 12 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 →

ZEPZELCA 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.

Extensive-Stage Small Cell Lung Cancer Metastatic Small Cell Lung Cancer

Drug Class

Alkylating Activity [MoA]Alkylating Drug [EPC]

Frequently Asked Questions

Is there an available Zepzelca billing and coding guide?

Billing and coding information for ZEPZELCA can be found through Jazz Pharmaceuticals. Visit Here →

Are there any available Zepzelca patient assistance programs?

ZEPZELCA patient assistance information can be found through Jazz Pharmaceuticals. Visit Here →

Where can I find Zepzelca prescribing information?

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

Where can I find Zepzelca side effect information?

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

Does billing ZEPZELCA require JZ/JW wastage modifiers?

CMS has identified ZEPZELCA(J9223) 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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