J9040 — Injection, bleomycin sulfate, 15 units
J9040 is a HCPCS Level II code for injection, bleomycin sulfate, 15 units. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of J9040 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 4 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 4 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- DME supplier
- 4 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for J9040
- Long descriptor
- Injection, bleomycin sulfate, 15 units
- Short descriptor
- Bleomycin sulfate injection
- Added
- January 1, 1984
- BETOS
- O1D
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to J9040
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J9040 is not quite right, the correct code is very often within a few positions of it.
- J9032Injection, belinostat, 10 mg
- J9033Injection, bendamustine hydrochloride, 1 mg
- J9034Injection, bendamustine hcl (bendeka), 1 mg
- J9035Injection, bevacizumab, 10 mg
- J9036Injection, bendamustine hydrochloride, (belrapzo/bendamustine), 1 mg
- J9037Injection, belantamab mafodotin-blmf, 0.5 mgterminated
- J9038Injection, axatilimab-csfr, 0.1 mg
- J9039Injection, blinatumomab, 1 microgram
- J9041Injection, bortezomib, 0.1 mg
- J9042Injection, brentuximab vedotin, 1 mg
- J9043Injection, cabazitaxel, 1 mg
- J9044Injection, bortezomib, not otherwise specified, 0.1 mgterminated
- J9045Injection, carboplatin, 50 mg
- J9046Injection, bortezomib (dr. reddy's), not therapeutically equivalent to j9041, 0.1 mg
- J9047Injection, carfilzomib, 1 mg
- J9048Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 0.1 mg
Questions about J9040
What is HCPCS code J9040?
J9040 is a HCPCS Level II code for injection, bleomycin sulfate, 15 units. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J9040?
The CMS HCPCS file marks J9040 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is J9040 paid under the physician fee schedule?
J9040 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).