Velcade (bortezomib) — HCPCS J9041

CareCost Estimate · Billing Cheat Sheet

Takeda (originally Millennium) 3.5 mg single-dose lyophilized vial SC (preferred) or IV bolus Reviewed: May 2, 2026 ASP: Q2 2026

HCPCS

J9041

1 unit = 0.1 mg

Dose

1.3 mg/m²

SC (preferred) · BSA-based

Modifier

Waste typical (3.5 mg vial)

Admin CPT

96401

Chemo SC — NOT 96372

ASP+6%

$2.253

/0.1 mg unit ($22.53/mg)

Biller error trap: 1 unit = 0.1 mg, NOT 1 mg. A 2.5 mg dose = 25 units, not 2.5. Always multiply mg administered × 10 to get billable units. Same trap on J9049 (generic) and J9054 (Boruzu).

SC route preferred — cuts peripheral neuropathy ~50% vs IV. SC concentration 2.5 mg/mL (1.4 mL diluent); IV concentration 1 mg/mL (3.5 mL diluent). Mixing them up is a 2.5× overdose risk. SC = 96401; IV bolus = 96409.

Codes & NDC

HCPCS	`J9041` — "Inj, bortezomib, 0.1 mg" (originator Velcade, Takeda)
NDC (brand)	`63020-049-01` / `63020-0049-01` — N4 qualifier
Vial	3.5 mg lyophilized single-dose vial
Reconstitution	SC: 1.4 mL 0.9% NaCl → 2.5 mg/mL · IV: 3.5 mL → 1 mg/mL
Benefit	Medical (provider buy-and-bill)

Brand vs generic vs Boruzu

Product	HCPCS	ASP+6% / 0.1 mg
Velcade (brand, Takeda)	`J9041`	$2.253
Bortezomib generic (Hospira)	`J9049`	$1.259 (~44% cheaper)
Boruzu premixed (Eagle)	`J9054`	verify CMS Q-file

Most payers prefer J9049 over J9041 for cost. Brand requires step-therapy through generic unless documented intolerance / contraindication / supply.

Regimens (1.3 mg/m² all)

Setting	Schedule	Cycle
NDMM transplant-eligible (VRd, VTD)	D 1, 4, 8, 11 (twice/wk × 2 wk)	21 d
NDMM transplant-ineligible (VMP)	Cy 1–4: 8 doses; Cy 5–9: weekly	42 d
NDMM transplant-ineligible (RVd-lite)	D 1, 8, 15, 22 (weekly × 4)	35 d
R/R MM (Vd, KPd, etc.)	D 1, 4, 8, 11 (twice/wk × 2 wk)	21 d
MCL 1L (with R-CHP)	Day 1 only	21 d

Administration & modifiers

Code	When
`96401`	Primary — chemo SC, non-hormonal (most common)
`96409`	Chemo IV push (IV bolus route)
`96372`	NOT appropriate — bortezomib is anti-neoplastic, requires chemo admin code
`96365`	NOT appropriate — bortezomib is bolus, not infusion

JW typical for waste: 3.5 mg vial vs BSA-calculated dose → ~1 mg discarded on average. Bill JW line for discarded units. JZ only when full vial used (BSA = 2.69 m² rare).

BSA → units (1.3 mg/m²)

BSA	Dose	Units	JW waste
1.5 m²	1.95 mg	20	~15
1.7 m²	2.21 mg	22	~13
1.92 m² (avg)	2.50 mg	25	10
2.0 m²	2.60 mg	26	9
2.2 m²	2.86 mg	29	6

ICD-10 — Multiple Myeloma

Code	For
`C90.00`	MM not in remission
`C90.01`	MM in remission
`C90.02`	MM in relapse
`C90.1x`	Plasma cell leukemia (rare subtype)
`C90.3x`	Solitary plasmacytoma (off-label, PA)

ICD-10 — Mantle Cell Lymphoma

Code	For
`C83.10`	MCL unspecified site
`C83.11`	Nodes head/face/neck
`C83.12`	Intrathoracic nodes
`C83.13`	Intra-abdominal nodes
`C83.18`	Multiple sites
`C83.19`	Extranodal / solid organ

Regimen acronym required. Most payers need VRd / VMP / RVd-lite / VR-CHP + line of therapy in PA. ICD-10 alone insufficient.

Payer requirements (May 2026)

Payer	PA	Brand vs generic stance
UnitedHealthcare	Yes	J9049 generic-preferred; J9041 needs justification
Aetna	Yes	Generic-preferred (oncology medical drug)
BCBS plans	Yes	Most generic-preferred; some allow brand parity
Medicare Advantage	Plan-dep.	Often follows commercial generic logic

Combo PA chains: lenalidomide REMS for VRd, daratumumab for VRd-Dara, etc. Submit in parallel; lenalidomide hold blocks the whole regimen.

Medicare reimbursement (Q2 2026)

Field	Value
J9041 ASP+6% (brand)	$2.253 / 0.1 mg ($22.53/mg)
J9049 ASP+6% (generic)	$1.259 / 0.1 mg ($12.59/mg)
2.5 mg dose (brand)	$56.33 (25 units × $2.253)
2.5 mg dose (generic)	$31.48 (25 units × $1.259)
Brand vs generic delta	~44% cheaper for J9049

Site of care

Setting	POS	Notes
Physician oncology office	11	Preferred — SC fits office workflow
Ambulatory infusion suite	49	Preferred
Oncology ASC	24	Acceptable
Hospital outpatient	19/22	Disfavored after 3 months
Patient home	12	Possible (SC); rare for oncology PI

Patient assistance — Takeda OnePath

Phone: 1-866-861-1750 (Takeda OnePath)
Velcade Co-pay: commercial $0 first dose, ongoing copay support (excludes federal payers)
PAP: Takeda Patient Assistance Foundation (uninsured / underinsured)
Medicare foundations: PAN, HealthWell, CancerCare, LLS Co-Pay — verify open MM funds quarterly
Web: takedaonepath.com / velcade.com

W&P (no formal boxed warning): peripheral neuropathy (dose-limiting; SC route cuts ~50%), hypotension, cardiac, pulmonary, PRES, GI events, thrombocytopenia, neutropenia, TLS, herpes zoster (acyclovir prophylaxis recommended), embryo-fetal tox.

Sources: Takeda Velcade HCP page, DailyMed (FDA label), Takeda OnePath, CMS ASP Q2 2026, NCCN MM v.2.2026 + B-cell Lymphomas (MCL), UHC/Aetna oncology policies, AMA CPT. carecostestimate.com/drugs/velcade