HCPCS code J9173: Durvalumab injection, per 10 mg2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for J9173 in California.

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

What J9173 covers

Durvalumab is an intravenous monoclonal antibody that blocks PD-L1, an immune checkpoint protein. Oncology clinicians administer it by infusion in settings such as physician-office infusion centers and hospital outpatient departments. It is used in cancer treatment regimens that include lung and biliary tract cancers; the chosen regimen and clinical setting determine when it is used. In some regimens it is given with another antineoplastic drug, such as tremelimumab.

J9173 represents 10 mg of durvalumab, so report one unit for each 10 mg administered. CMS assigns this code physician fee schedule status E, meaning it is excluded from the physician fee schedule; when Medicare covers the drug, payment is made under another method. CMS classifies it as a Part B drug, generally priced from its quarterly Average Sales Price 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 J9173 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the J9173 rate is calculated

Each of J9173’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 J9173

J9173 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.

J9173 compared with similar codes

How to choose

J9271PembrolizumabPer 1 mg

J9271 identifies pembrolizumab, not durvalumab. Select the code for the drug actually administered; the agents are not interchangeable code choices.

J9299NivolumabPer 1 mg

J9299 identifies nivolumab. J9173 is specific to durvalumab, even when treatment settings or cancer types overlap.

J9347Tremelimumab-actlPer 1 mg

J9347 identifies tremelimumab-actl, a separate drug that may be paired with durvalumab. Report each drug under its own code when administered.

Codes related to J9173

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

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