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HCPCS code J1449: Eflapegrastim injection, per 0.1 mg2026 Medicare rate & RVUs

Reports eflapegrastim-xnst administered by injection to reduce febrile neutropenia risk during myelosuppressive chemotherapy in adults with nonmyeloid cancers.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J1449

Eflapegrastim injection, per 0.1 mg

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for J1449 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What J1449 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What J1449 covers

J1449 identifies eflapegrastim-xnst (Rolvedon), a long-acting granulocyte colony-stimulating factor given by subcutaneous injection. Oncology practices use it for adults with nonmyeloid cancers receiving myelosuppressive chemotherapy associated with a clinically significant risk of febrile neutropenia. The drug supports neutrophil recovery and helps reduce febrile neutropenia risk during chemotherapy. It is administered once per chemotherapy cycle.

CMS assigns this code physician fee schedule status E, meaning it is excluded from the physician fee schedule. When Medicare covers the drug, payment is under another method; CMS classifies it as a Part B drug, generally priced using the quarterly Average Sales Price drug files. Coverage is left to the Medicare contractor's judgment. Each billing unit represents 0.1 mg, so a 13.2-mg administration corresponds to 132 units. Document the amount administered.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where J1449 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

J1449 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

J1449 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
J1449 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the J1449 rate is calculated

Each of J1449’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · J1449

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for J1449

J1449 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · J1449

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

J1449 isn’t priced in this setting.

J1449 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • J1449

    Eflapegrastim injection, per 0.1 mg0 wRVU

    Not priced

  • J1442

    Filgrastim injection, per 1 microgram0 wRVU

    Not priced

  • J1447

    Tbo-filgrastim, per 1 mcg0 wRVU

    Not priced

  • J2506

    Pegfilgrastim injection, per 0.5 mg0 wRVU

    Not priced

How to choose

J1442Filgrastim injectionPer 1 microgram
J1442 is for filgrastim, not eflapegrastim-xnst. Select the code for the specific drug administered.
J1447Tbo-filgrastimPer 1 mcg
J1447 identifies tbo-filgrastim. J1449 identifies eflapegrastim-xnst; these are distinct drugs.
J2506Pegfilgrastim injectionPer 0.5 mg
J2506 identifies pegfilgrastim, rather than eflapegrastim-xnst. Report the code corresponding to the product administered.

Codes related to J1449

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to J1449
CodeHow it relatesNational office range
Used instead
J1442Filgrastim injection, per 1 microgramReports filgrastim, another granulocyte colony-stimulating factor used to support neutrophil recovery.No office rate
J1447Tbo-filgrastim, per 1 mcgReports tbo-filgrastim, an alternative granulocyte colony-stimulating factor.No office rate
J2506Pegfilgrastim injection, per 0.5 mgReports pegfilgrastim, another long-acting granulocyte colony-stimulating factor.No office rate

J1449 billing questions

What does one unit of J1449 represent?

One unit represents 0.1 mg of eflapegrastim-xnst. A 13.2-mg administration corresponds to 132 units.

How does J1449 differ from filgrastim or pegfilgrastim codes?

J1449 is for eflapegrastim-xnst. J1442 describes filgrastim, while J2506 describes pegfilgrastim; use the code matching the drug administered.

Does Medicare pay J1449 under the physician fee schedule?

No. CMS assigns status E, excluding it from the physician fee schedule; when covered, Medicare pays under another method as a Part B drug.

Is J1449 automatically covered by Medicare?

No. Coverage is left to the Medicare contractor's judgment.

What documentation supports the units reported?

Document the eflapegrastim-xnst product and the amount administered. Calculate units using 0.1 mg per unit.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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