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HCPCS code J9042: Brentuximab vedotin, per 1 mg2026 Medicare rate & RVUs

J9042 identifies brentuximab vedotin, an intravenous antineoplastic drug reported by oncology practices for each 1 mg administered.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J9042

Brentuximab vedotin, per 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 J9042 →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 J9042 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 J9042 covers

J9042 identifies brentuximab vedotin, an antibody-drug conjugate given by intravenous infusion. Oncology practices and hospital outpatient departments report the drug when administering it for conditions such as Hodgkin lymphoma, systemic anaplastic large cell lymphoma, or other CD30-positive lymphomas. The drug is used in treatment plans that vary by diagnosis and clinical circumstances; the code identifies the drug, not the infusion service.

CMS assigns J9042 physician fee schedule status E, excluding it from the physician fee schedule. When Medicare covers the drug, it generally pays through the Part B drug method using CMS quarterly Average Sales Price pricing files; coverage is left to the Medicare contractor’s judgment. Report one unit for each 1 mg administered. Report the infusion administration separately when applicable, using the code that describes the service performed.

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 J9042 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

J9042 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

J9042 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
J9042 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 J9042 rate is calculated

Each of J9042’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 · J9042

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 J9042

J9042 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 · J9042

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

J9042 isn’t priced in this setting.

J9042 compared with similar codes

Compare codes · National

J9042 vs J9041 vs J9039: Medicare rates

Office or facility?

  • J9042

    Brentuximab vedotin, per 1 mg0 wRVU

    Not priced

  • J9041

    Bortezomib injection, per 0.1 mg0 wRVU

    Not priced

  • J9039

    Blinatumomab, per 1 mcg0 wRVU

    Not priced

How to choose

J9041Bortezomib injectionPer 0.1 mg
J9041 identifies bortezomib, a different antineoplastic drug. Use J9042 for brentuximab vedotin.
J9039BlinatumomabPer 1 mcg
J9039 identifies blinatumomab, not brentuximab vedotin. Select the code for the drug actually administered.

Codes related to J9042

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

Codes related to J9042
CodeHow it relatesNational office range
Often billed with
96413Chemo IV infusion, initial drug, first hourReports the initial-hour chemotherapy infusion administration service when performed.$114.99–$186.95
J9000Doxorubicin injection, per 10 mgDoxorubicin may be administered with brentuximab vedotin in an A+AVD regimen.No office rate
J9360Vinblastine injection, per 1 mgVinblastine may be administered with brentuximab vedotin in an A+AVD regimen.No office rate
J9130Dacarbazine injection, per 100 mgDacarbazine may be administered with brentuximab vedotin in an A+AVD regimen.No office rate

J9042 billing questions

What drug does J9042 identify?

It identifies brentuximab vedotin, an intravenous antineoplastic drug. It is not a general code for lymphoma drugs.

How many units should be reported?

Each unit represents 1 mg of brentuximab vedotin administered. Calculate units from the administered dose in milligrams.

Does J9042 include the infusion service?

No. J9042 identifies the drug; report the applicable infusion administration service separately when performed.

How does Medicare treat J9042?

CMS excludes it from the physician fee schedule with status E. When covered, it generally uses the Part B drug payment method based on quarterly ASP pricing files, and coverage is left to the Medicare contractor.

How is J9042 different from J9041?

J9042 identifies brentuximab vedotin, while J9041 identifies bortezomib. They are different drugs and their codes are not interchangeable.

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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