HCPCS code J1449: Eflapegrastim injection, per 0.1 mg2026 Medicare rate & RVUs in Michigan
Reports eflapegrastim-xnst administered by injection to reduce febrile neutropenia risk during myelosuppressive chemotherapy in adults with nonmyeloid cancers.
CMS doesn’t publish an office rate for J1449 in Michigan.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | Unavailable |
| Rest of Michigan | Unavailable | Unavailable |
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
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
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J1449 isn’t priced in this setting.
J1449 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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