HCPCS code J9206: Irinotecan injection, per 20 mg2026 Medicare rate & RVUs

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

What J9206 covers

Irinotecan is an antineoplastic drug used in chemotherapy regimens, especially for colorectal cancer. Oncology practices and hospital outpatient departments commonly report the drug when it is administered by intravenous infusion. The drug code identifies the medication; the infusion service is a separate service when appropriately reportable.

Each J9206 unit represents 20 mg of irinotecan, so the units reflect the administered amount divided by 20 mg. 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 through another method; HCPCS classifies it as a Part B drug generally priced using CMS quarterly Average Sales Price files. Special Medicare coverage instructions apply.

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 J9206 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

J9206 rates by state

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

How the J9206 rate is calculated

Each of J9206’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 J9206

J9206 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.

J9206 compared with similar codes

How to choose

J9205Liposomal irinotecanPer 1 mg

J9205 is for liposomal irinotecan and uses a 1 mg unit. J9206 is for conventional irinotecan and uses a 20 mg unit.

96413Chemo IV infusionInitial drug, first hour

J9206 reports the irinotecan drug. 96413 reports chemotherapy administration by infusion for up to one hour, when that service is performed.

J9190Fluorouracil injection500 mg per unit

J9190 identifies fluorouracil, a different chemotherapy drug often used with irinotecan in FOLFIRI; it is not the drug code for irinotecan.

Codes related to J9206

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