HCPCS code J9029: Adstiladrin, per therapeutic dose2026 Medicare rate & RVUs in Missouri
Nadofaragene firadenovec is a bladder-instilled gene therapy reported per therapeutic dose for adults with certain high-risk, BCG-unresponsive bladder cancer.
CMS doesn’t publish an office rate for J9029 in Missouri.
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 J9029 covers
J9029 identifies nadofaragene firadenovec-vncg, marketed as Adstiladrin, for delivery into the bladder through a urinary catheter. Urologists typically administer it in an outpatient setting for adults with high-risk, BCG-unresponsive non-muscle-invasive bladder cancer with carcinoma in situ, with or without papillary tumors. It is a local bladder treatment, not an intravenous or intramuscular injection.
Report one unit for each therapeutic dose administered; the unit is not a milliliter or a count of viral particles. CMS excludes J9029 from the physician fee schedule under status E. CMS classifies it as a Part B drug, generally priced from quarterly Average Sales Price files when covered. Coverage is left to the Medicare contractor’s judgment.
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 J9029 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
How the J9029 rate is calculated
Each of J9029’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 · J9029
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 J9029
J9029 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 · J9029
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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J9029 isn’t priced in this setting.
J9029 compared with similar codes
Compare codes · National
J9029 vs J9030 vs 51720: Medicare rates
How to choose
J9029 billing questions
What does one unit of J9029 represent?
One unit represents one therapeutic dose of nadofaragene firadenovec. Do not calculate units from the instilled volume or viral-particle count.
Is J9029 the drug or the bladder-instilling service?
J9029 identifies the drug per therapeutic dose. CPT 51720 describes the bladder instillation service and may be reported for the administration when applicable.
How does Medicare treat J9029?
CMS assigns status E, excluding the code from the physician fee schedule. When covered, it is treated as a Part B drug and generally priced using CMS quarterly ASP files.
Does Medicare coverage follow automatically from the code?
No. Coverage is left to the Medicare contractor’s judgment.
How is J9029 different from J9030?
J9029 is nadofaragene firadenovec gene therapy per therapeutic dose. J9030 identifies intravesical live BCG per milligram, a different bladder treatment.
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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