HCPCS code J9205: Liposomal irinotecan, per 1 mg2026 Medicare rate & RVUs in Riverside, CA

CMS doesn’t publish a rate for J9205 in Riverside, CA.

Check a contract rate as a % of Medicare · J9205 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 J9205 covers

J9205 identifies the liposomal formulation of irinotecan, an antineoplastic drug administered by intravenous infusion. Oncology clinicians administer it in intravenous chemotherapy regimens, and oncology practices report the drug dose. For metastatic pancreatic adenocarcinoma, it is used with fluorouracil and leucovorin after disease progression following gemcitabine-based therapy; a first-line regimen also combines it with oxaliplatin, fluorouracil, and leucovorin. The liposomal formulation is distinct from conventional irinotecan, so code the product actually administered.

Each HCPCS unit represents 1 mg of liposomal irinotecan; report units based on the milligrams administered. CMS assigns physician fee schedule status E, meaning the drug is excluded from the physician fee schedule by regulation. When Medicare covers it, payment is under another method; the HCPCS pricing method identifies it as a Part B drug generally paid from CMS's quarterly ASP drug pricing files. CMS's coverage code calls for special Medicare coverage instructions.

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 Riverside, CA compares for J9205

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J9205 rates by state

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

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How the J9205 rate is calculated

Each of J9205’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 J9205

J9205 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 J9205

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

How J9205 has changed in Riverside, CA

Price J9205 for an earlier date of service

Where the Riverside, CA rate applies

Riverside, CA is a Medicare payment area, not a city. Our Census mapping connects it to 127 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.

• Ontario
• Riverside
• San Bernardino
• Adelanto
• Aguanga
• Anza
• Apple Valley
• Baker

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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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