HCPCS code J9206: Irinotecan injection, per 20 mg2026 Medicare rate & RVUs in Michigan
Reports conventional irinotecan supplied for cancer treatment, commonly in colorectal cancer regimens, with each unit representing 20 mg of the drug.
CMS doesn’t publish an office rate for J9206 in Michigan.
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 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 in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | Unavailable |
| Rest of Michigan | Unavailable | Unavailable |
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.
How the rate is built · J9206
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 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.
Place of service · J9206
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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J9206 isn’t priced in this setting.
J9206 compared with similar codes
Compare codes · National
4 codes, side by side
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.
J9206 billing questions
How many units should be reported?
One unit represents 20 mg of irinotecan. Calculate units from the administered dose in 20 mg increments.
How does J9206 differ from J9205?
J9206 identifies conventional irinotecan, while J9205 identifies the liposomal formulation. Select the code for the formulation administered; their units represent different amounts.
Does J9206 include the chemotherapy infusion service?
No. J9206 identifies the drug. Report an appropriate chemotherapy administration service separately when performed and supported by the encounter.
How does Medicare price this drug when covered?
CMS excludes J9206 from the physician fee schedule under status E. When covered, it is paid through another method; HCPCS classifies it as a Part B drug generally priced from quarterly CMS ASP files.
What should the medical record support?
Document the irinotecan product administered, the dose, and the administration record so the reported units can be reconciled to the amount given.
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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