ZOLADEX J Code: J9202

Drug & Product Overview

HCPCS Descriptor Goserelin acetate implant, per 3.6 mg

HCPCS Added Date January 1, 1991

Manufacturer Multiple Manufacturers

Route of Administration Subcutaneous

Generic Status Multi-Source; Generic

Dosage Type Single-Dose

Dosage Form Implant

About ZOLADEX

Zoladex is a medication aligned to the HCPCS J Code: J9202 for billing, pricing, and reimbursement purposes in the United States. It is an Oncology drug administered via the subcutaneous route and manufactured by multiple companies.

According to CMS Drug Use Information: Goserelin is used to treat certain types of cancer (prostate and breast). It is also used to thin the lining of the uterus (endometrium) in preparation for a procedure to treat abnormal uterine bleeding. Goserelin is also used to treat a condition in which the tissue that normally lines the inside of the uterus also grows outside the uterus (endometriosis). Talk to your doctor about the risks and benefits of treatment. Goserelin is similar to a natural hormone made by the body (luteinizing hormone releasing hormone-LHRH). It works by decreasing testosterone hormones and estrogen hormones. This effect helps to slow or stop the growth of certain cancer cells and uterine tissue that need these hormones to grow and spread.

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	Package	Manufacturer	HCPCS Units	WAC	AWP
70720-0950-36	3.6 MG Zoladex Subcutaneous Implant 3.6 MG/1 - 1 POUCH in 1 CARTON (70720-950-36) / 1 SYRINGE in 1 POUCH / 1 IMPLANT in 1 SYRINGE	TerSera Therapeutics LLC	1	$1,179.02 $1,179.02 / unit	$1,414.82 $1,414.82 / unit
70720-0951-30	10.8 MG Zoladex Subcutaneous Implant 10.8 MG/1 - 1 POUCH in 1 CARTON (70720-951-30) / 1 SYRINGE in 1 POUCH / 1 IMPLANT in 1 SYRINGE	TerSera Therapeutics LLC	3	$3,212.91 $1,070.97 / unit	$3,855.49 $1,285.163 / unit

Effective 1/1/26 (WAC & AWP)

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ZOLADEX Pricing & Reimbursement

J9202 Private Payer Reimbursement

$799.38 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

NDC Package

HCPCS Units

Markup / Markdown

%

Common:

Estimates only. Payer reimbursement varies by contract, site of care, and sequestration.

Estimated Reimbursement

ZOLADEX CPT Administration Codes

CPT Code	Description
96402	Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic

JW / JZ modifiers apply

CMS has identified Zoladex (J9202) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ZOLADEX Medically Unlikely Edits (MUE)

The most billing units of J9202 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 3.6 mg.

Practitioner Office & Hospital Outpatient

3 units / day

= 10.8 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 →

ZOLADEX 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.

Advanced Breast Cancer Advanced Prostatic Carcinoma Endometrial Thinning Endometriosis Stage B2-C Prostatic Carcinoma

Drug Class

Gonadotropin Releasing Hormone Receptor Agonist [EPC]Gonadotropin Releasing Hormone Receptor Agonists [MoA]

Frequently Asked Questions

Is there an available Zoladex billing and coding guide?

Billing and coding information for ZOLADEX can be found through Tersera Therapeutics. Visit Here →

Are there any available Zoladex patient assistance programs?

ZOLADEX patient assistance information can be found through Tersera Therapeutics. Visit Here →

Where can I find Zoladex prescribing information?

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

Where can I find Zoladex side effect information?

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

Does billing ZOLADEX require JZ/JW wastage modifiers?

CMS has identified ZOLADEX(J9202) 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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