Arsenic trioxide injection
Products billed under this code include Arsenic Trioxide, Trisenox.
Payment limit per 1 MG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under J9017
From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Arsenic Trioxide | Sandoz Inc. | 00781-3498-94 | 12 | $46.044 |
| Arsenic Trioxide | Sandoz Inc. | 00781-3498-95 | 120 | $460.44 |
| Arsenic Trioxide | Nexus Pharmaceuticals, LLC | 14789-0600-10 | 100 | $383.70 |
| Arsenic Trioxide | Heritage Pharmaceuticals Inc. | 23155-0869-41 | 100 | $383.70 |
| Arsenic Trioxide | Heritage Pharmaceuticals Inc. | 23155-0870-41 | 120 | $460.44 |
| Arsenic Trioxide | Sagent Pharmaceuticals | 25021-0226-10 | 100 | $383.70 |
| Arsenic Trioxide | Sagent Pharmaceuticals | 25021-0227-06 | 120 | $460.44 |
| Arsenic Trioxide | Ingenus Pharmaceuticals LLC | 50742-0438-10 | 10 | $38.37 |
| Arsenic Trioxide | FreseniUS Kabi USA, LLC | 63323-0637-10 | 100 | $383.70 |
| Arsenic Trioxide | Zydus Pharmaceuticals (USA) Inc. | 68382-0997-10 | 100 | $383.70 |
Show all 22 products
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Arsenic Trioxide | Nordic Pharma, Inc | 69918-0720-02 | 20 | $76.74 |
| Arsenic Trioxide | Nordic Pharma, Inc | 69918-0720-10 | 100 | $383.70 |
| Arsenic Trioxide | Amneal Pharmaceuticals, LLC | 70121-1483-07 | 100 | $383.70 |
| Arsenic Trioxide | Amneal Pharmaceuticals, LLC | 70121-1658-01 | 120 | $460.44 |
| Arsenic Trioxide | Zydus Pharmaceuticals (USA) Inc. | 70710-1610-06 | 120 | $460.44 |
| Arsenic Trioxide | Zydus Pharmaceuticals (USA) Inc. | 70710-1895-06 | 100 | $383.70 |
| Arsenic Trioxide | Zydus Pharmaceuticals (USA) Inc. | 70710-1896-06 | 120 | $460.44 |
| Arsenic Trioxide | Athenex Pharmaceutical Division, LLC | 70860-0217-10 | 10 | $38.37 |
| Arsenic Trioxide | Novadoz Pharmaceuticals LLC | 72205-0171-07 | 100 | $383.70 |
| Arsenic Trioxide | Novadoz Pharmaceuticals LLC | 72205-0172-07 | 120 | $460.44 |
| Arsenic Trioxide | Northstar RxLLC | 72603-0339-10 | 100 | $383.70 |
| Trisenox | Cephalon, LLC | 63459-0601-06 | 120 | $460.44 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $3.837 | −$1.232 | 1 MG | Arsenic trioxide injection | v1, posted September 17, 2026 |
| 3Q26 | $5.069 | −$1.376 | 1 MG | Arsenic trioxide injection | v1, posted September 15, 2026 |
| 2Q26 | $6.445 | −$0.943 | 1 MG | Arsenic trioxide injection | v1, posted September 15, 2026 |
| 1Q26 | $7.388 | −$0.765 | 1 MG | Arsenic trioxide injection | v1, posted September 15, 2026 |
| 4Q25 | $8.153 | +$2.296 | 1 MG | Arsenic trioxide injection | v1, posted September 8, 2026 |
| 3Q25 | $5.857 | +$1.067 | 1 MG | Arsenic trioxide injection | v1, posted March 10, 2026 |
| 2Q25 | $4.79 | +$0.109 | 1 MG | Arsenic trioxide injection | v1, posted March 10, 2026 |
| 1Q25 | $4.681 | −$2.518 | 1 MG | Arsenic trioxide injection | v1, posted December 19, 2025 |
| 4Q24 | $7.199 | −$3.488 | 1 MG | Arsenic trioxide injection | v1, posted June 11, 2025 |
| 3Q24 | $10.687 | −$1.212 | 1 MG | Arsenic trioxide injection | v1, posted June 11, 2025 |
| 2Q24 | $11.899 | −$3.884 | 1 MG | Arsenic trioxide injection | v1, posted March 11, 2025 |
| 1Q24 | $15.783 | −$2.716 | 1 MG | Arsenic trioxide injection | v1, posted December 19, 2024 |
| 4Q23 | $18.499 | +$5.533 | 1 MG | Arsenic trioxide injection | v1, posted October 10, 2024 |
| 3Q23 | $12.966 | −$0.732 | 1 MG | Arsenic trioxide injection | v1, posted June 5, 2024 |
| 2Q23 | $13.698 | −$2.209 | 1 MG | Arsenic trioxide injection | v1, posted February 23, 2024 |
| 1Q23 | $15.907 | +$0.536 | 1 MG | Arsenic trioxide injection | v1, posted December 6, 2023 |
| 4Q22 | $15.371 | +$3.037 | 1 MG | Arsenic trioxide injection | v1, posted June 22, 2023 |
| 3Q22 | $12.334 | −$1.878 | 1 MG | Arsenic trioxide injection | v1, posted June 9, 2023 |
| 2Q22 | $14.212 | +$1.401 | 1 MG | Arsenic trioxide injection | v1, posted December 14, 2022 |
| 1Q22 | $12.811 | −$0.303 | 1 MG | Arsenic trioxide injection | v1, posted June 8, 2022 |
| 4Q21 | $13.114 | −$5.317 | 1 MG | Arsenic trioxide injection | v1, posted June 2, 2022 |
| 3Q21 | $18.431 | −$5.267 | 1 MG | Arsenic trioxide injection | v1, posted June 2, 2022 |
| 2Q21 | $23.698 | +$5.875 | 1 MG | Arsenic trioxide injection | v1, posted March 1, 2022 |
| 1Q21 | $17.823 | – | 1 MG | Arsenic trioxide injection | v1, posted December 10, 2021 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.
CMS source files
- 4Q26: 2026-09-17_october-2026-medicare-part-b-payment-limit-files-final.zipposted September 17, 2026
- 4Q26: 2026-09-17_october-2026-ndc-hcpcs-crosswalk-final.zipposted September 17, 2026
- 3Q26: 2026-09-15_july-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 2Q26: 2026-09-15_april-2026-medicare-part-b-payment-limit-files-final-file.zipposted September 15, 2026
- 1Q26: 2026-09-15_january-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 4Q25: 2026-09-08_october-2025-asp-pricing-final-file.zipposted September 8, 2026
- 3Q25: 2026-03-10_july-2025-asp-pricing-file.zipposted March 10, 2026
- 2Q25: 2026-03-10_april-2025-asp-pricing-file.zipposted March 10, 2026
- 1Q25: 2025-12-19_january-2025-asp-pricing-file-03-11-25-final-file.zipposted December 19, 2025
- 4Q24: 2025-06-11_october-2024-asp-pricing-file.zipposted June 11, 2025
- 3Q24: 2025-06-11_july-2024-asp-pricing-file.zipposted June 11, 2025
- 2Q24: 2025-03-11_april-2024-asp-pricing-file.zipposted March 11, 2025
- 1Q24: 2024-12-19_january-2024-asp-pricing-file.zipposted December 19, 2024
- 4Q23: 2024-10-10_october-2023-asp-pricing-file.zipposted October 10, 2024
- 3Q23: 2024-06-05_july-2023-asp-pricing-file.zipposted June 5, 2024
- 2Q23: 2024-02-23_april-2023-asp-pricing-file.zipposted February 23, 2024
- 1Q23: 2023-12-06_january-2023-asp-pricing-file.zipposted December 6, 2023
- 4Q22: 2023-06-22_october-2022-asp-pricing-file.zipposted June 22, 2023
- 3Q22: 2023-06-09_july-2022-asp-pricing-file.zipposted June 9, 2023
- 2Q22: 2022-12-14_april-2022-asp-pricing-file.zipposted December 14, 2022
- 1Q22: 2022-06-08_january-2022-asp-pricing-file.zipposted June 8, 2022
- 4Q21: 2022-06-02_october-2021-asp-pricing-file.zipposted June 2, 2022
- 3Q21: 2022-06-02_july-2021-asp-pricing-file.zipposted June 2, 2022
- 2Q21: 2022-03-01_april-2021-asp-pricing-file.zipposted March 1, 2022
- 1Q21: 2021-12-10_january-2021-asp-pricing-file.zipposted December 10, 2021