HCPCS code J9023: Avelumab injection, per 10 mg2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for J9023 in California.

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

What J9023 covers

Avelumab is an immune checkpoint inhibitor given by intravenous infusion. Oncology practices and hospital outpatient departments commonly report it for treatment regimens involving certain advanced cancers, including Merkel cell carcinoma, urothelial carcinoma, and renal cell carcinoma. The selected drug and regimen depend on the patient’s cancer and treatment plan; avelumab may be used with another cancer drug in some regimens.

J9023 is excluded from the physician fee schedule under CMS status E. When Medicare covers the drug, it is treated as a Part B drug, generally priced through CMS’s quarterly ASP drug pricing files; coverage is left to the Medicare contractor’s judgment. Each HCPCS unit represents 10 mg of avelumab, so the number of units is based on the administered dose divided by 10 mg. Report the drug separately from the applicable infusion-administration service when appropriate.

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 J9023 pays more and less in California

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

29 of 29 payment localities

How the J9023 rate is calculated

Each of J9023’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.

Payment rules and modifiers for J9023

J9023 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.

J9023 compared with similar codes

How to choose

J9022Atezolizumab injectionPer 10 mg

J9022 identifies atezolizumab, not avelumab. Both codes use a 10 mg unit, so select according to the drug administered.

J9024Atezolizumab injectionPer 5 mg

J9024 identifies an atezolizumab and hyaluronidase product. It is not avelumab; use J9023 only when avelumab was administered.

Codes related to J9023

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

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