HCPCS code J9038: Axatilimab injection, per 0.1 mg2026 Medicare rate & RVUs in Missouri
Reports axatilimab-csfr, an intravenous treatment for chronic graft-versus-host disease, in units representing each 0.1 mg administered.
CMS doesn’t publish an office rate for J9038 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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On this page 9 sections
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 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 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
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
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J9038 isn’t priced in this setting.
J9038 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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