HCPCS code J9263: Oxaliplatin, per 0.5 mg2026 Medicare rate & RVUs in Florida
HCPCS Level II drug code for intravenous oxaliplatin, reported by dose administered during chemotherapy, commonly in fluorouracil- and leucovorin-based cancer regimens.
CMS doesn’t publish an office rate for J9263 in Florida.
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 J9263 covers
J9263 identifies oxaliplatin, an antineoplastic drug given by intravenous infusion. Oncology clinicians commonly use it in colorectal cancer treatment, including fluorouracil- and leucovorin-based regimens. Hospital outpatient infusion departments and physician-office infusion practices may report the drug when it is administered as part of chemotherapy. The drug code represents the medication, not the infusion service itself.
CMS assigns this code physician fee schedule status E, meaning it is excluded from the physician fee schedule. When Medicare covers the drug, it is treated as a Part B drug and generally priced using CMS’s quarterly Average Sales Price drug pricing files. Coverage is left to the Medicare contractor’s judgment. One J9263 unit represents 0.5 mg of oxaliplatin; for example, 1 mg corresponds to 2 units. Report units based on the amount administered and supported by the medication record.
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 J9263 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | Unavailable |
| Miami, FL | Unavailable | Unavailable |
| Rest of Florida | Unavailable | Unavailable |
How the J9263 rate is calculated
Each of J9263’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 · J9263
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 J9263
J9263 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 · J9263
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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J9263 isn’t priced in this setting.
J9263 compared with similar codes
Compare codes · National
J9263 vs J9045 vs J9060: Medicare rates
How to choose
- J9045CarboplatinPer 50 mg
- J9045 identifies carboplatin, another platinum chemotherapy drug. Select the code for the drug actually administered; it is not an oxaliplatin code.
- J9060Cisplatin injectionPer 10 mg
- J9060 identifies cisplatin. Although both are platinum drugs, J9263 is specific to oxaliplatin.
J9263 billing questions
How many units does J9263 represent?
Each unit represents 0.5 mg of oxaliplatin. A 1 mg administered dose corresponds to 2 units.
Does J9263 include the chemotherapy infusion service?
No. J9263 identifies the drug. Report an applicable chemotherapy administration service separately when performed and reportable.
How does Medicare treat J9263?
It has physician fee schedule status E and is excluded from the physician fee schedule. When covered, it is a Part B drug generally priced from CMS quarterly ASP drug pricing files; coverage is determined by the Medicare contractor.
What documentation supports the units billed?
The medication administration record should support the oxaliplatin dose administered. Convert the dose to 0.5 mg units.
Should J9263 be used for carboplatin?
No. J9263 identifies oxaliplatin; use the code for the specific drug administered. Carboplatin has a different HCPCS code.
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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