HCPCS code J9173: Durvalumab injection, per 10 mg2026 Medicare rate & RVUs in Georgia
Durvalumab is an intravenous cancer immunotherapy reported by oncology practices for each 10 mg administered in treatment regimens for selected cancers.
CMS doesn’t publish an office rate for J9173 in Georgia.
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 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 Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta, GA | Unavailable | Unavailable |
| Rest of Georgia | Unavailable | Unavailable |
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.
How the rate is built · J9173
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 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.
Place of service · J9173
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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J9173 isn’t priced in this setting.
J9173 compared with similar codes
Compare codes · National
4 codes, side by side
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.
J9173 billing questions
How many units should be reported?
Each unit represents 10 mg of durvalumab. Divide the administered dose in milligrams by 10 to determine the units.
Which drug does J9173 identify?
It identifies durvalumab, an intravenous cancer immunotherapy. Do not select it for another infusion drug just because it is used in a similar cancer treatment setting.
Is the infusion administration reported with the drug?
The drug code identifies the durvalumab administered; the infusion service is a separate coding consideration. Code 96413 is commonly reported for an initial chemotherapy infusion service when its requirements are met.
How does Medicare treat J9173?
CMS excludes it from the physician fee schedule with status E. When covered, it is a Part B drug generally priced through CMS's quarterly ASP drug files, and coverage is left to the Medicare contractor's judgment.
Can J9173 be reported with tremelimumab?
The drugs may be administered together in a cancer regimen. J9173 reports durvalumab, while J9347 identifies tremelimumab-actl.
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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