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HCPCS code J9038: Axatilimab injection, per 0.1 mg2026 Medicare rate & RVUs

Reports axatilimab-csfr, an intravenous treatment for chronic graft-versus-host disease, in units representing each 0.1 mg administered.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J9038

Axatilimab 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 J9038 →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 J9038 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 J9038 covers

J9038 identifies axatilimab-csfr (Niktimvo), a monoclonal antibody given by intravenous infusion. It is used to treat chronic graft-versus-host disease after at least two prior systemic therapies have failed. Oncology and hematology practices commonly report the drug when it is furnished for infusion in an outpatient setting; the treating team administers and documents the dose and route.

Each HCPCS unit represents 0.1 mg of axatilimab-csfr, so 1 mg corresponds to 10 units. CMS assigns the code physician fee schedule status E, meaning it is excluded from the physician fee schedule; when Medicare covers it, payment is made under another method. CMS classifies it as a Part B drug, generally priced from quarterly ASP drug 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 J9038 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

J9038 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

J9038 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
J9038 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 J9038 rate is calculated

Each of J9038’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 · J9038

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 J9038

J9038 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 · J9038

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

J9038 isn’t priced in this setting.

J9038 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • J9038

    Axatilimab injection, per 0.1 mg0 wRVU

    Not priced

  • J9026

    Tarlatamab injection, per 1 mg0 wRVU

    Not priced

  • J9039

    Blinatumomab, per 1 mcg0 wRVU

    Not priced

  • J3590

    Unclassified biologic, no product-specific code0 wRVU

    Not priced

How to choose

J9026Tarlatamab injectionPer 1 mg
J9026 identifies tarlatamab-dlle, not axatilimab-csfr. Select the code for the drug furnished; their dose units differ.
J9039BlinatumomabPer 1 mcg
J9039 identifies blinatumomab, a different biologic drug. J9038 is specific to axatilimab-csfr and uses 0.1 mg units.
J3590Unclassified biologicNo product-specific code
J3590 is an unclassified biologics code; J9038 is the specific code for axatilimab-csfr.

Codes related to J9038

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

Codes related to J9038
CodeHow it relatesNational office range
Often billed with
96413Chemo IV infusion, initial drug, first hourReports the initial qualifying intravenous chemotherapy or biologic infusion service separately from the drug.$114.99–$186.95

J9038 billing questions

What does one J9038 unit represent?

One unit represents 0.1 mg of axatilimab-csfr. For example, 1 mg corresponds to 10 units.

When is axatilimab-csfr used?

It is an intravenous treatment for chronic graft-versus-host disease after at least two prior systemic therapies have failed.

Does J9038 include the infusion service?

J9038 reports the drug amount. A separately reportable infusion-administration service may be reported with the applicable administration code.

How does Medicare treat J9038?

CMS excludes it from the physician fee schedule (status E). When covered, it is a Part B drug generally priced through quarterly ASP files, and coverage is left to the Medicare contractor’s judgment.

How is J9038 different from J9026?

J9026 identifies tarlatamab-dlle, measured per 1 mg; J9038 identifies axatilimab-csfr, measured per 0.1 mg.

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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