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

CMS doesn’t publish a rate for J9038 in Puerto Rico.

Check a contract rate as a % of Medicare · J9038 nationwide

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

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.

How Puerto Rico compares for J9038

Every other payment area

J9038 rates by state

Office rate range in each state. Select a state to see its payment localities.

See J9038 in every payment locality

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.

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.

Codes related to J9038

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

How J9038 has changed in Puerto Rico

Price J9038 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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