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HCPCS code J9271: Pembrolizumab, per 1 mg2026 Medicare rate & RVUs

Reports pembrolizumab quantity in 1 mg units for cancer immunotherapy, commonly administered by intravenous infusion in oncology clinics and hospital settings.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J9271

Pembrolizumab, per 1 mg

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for J9271 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What J9271 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What J9271 covers

Pembrolizumab is an anti-PD-1 monoclonal antibody used as immunotherapy for several cancers. Oncology clinicians commonly administer it by intravenous infusion in outpatient cancer centers and hospital settings. J9271 represents the amount of pembrolizumab for the patient's treatment; it does not describe infusion duration or administration work.

CMS excludes J9271 from the physician fee schedule under status E. When Medicare covers the drug, payment is made under another method; the HCPCS pricing classification identifies it as a Part B drug, generally priced through CMS quarterly Average Sales Price files. Coverage is determined by the Medicare contractor. One unit represents 1 mg of pembrolizumab.

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 J9271 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

J9271 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

J9271 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
J9271 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the J9271 rate is calculated

Each of J9271’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 · J9271

RVUs × geographic indexes × conversion factor

Office or facility?

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 J9271

J9271 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 · J9271

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

J9271 isn’t priced in this setting.

J9271 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • J9271

    Pembrolizumab, per 1 mg0 wRVU

    Not priced

  • J9277

    Pembrolizumab injection, with hyaluronidase, per 1 mg0 wRVU

    Not priced

  • J9272

    Dostarlimab injection, per 10 mg0 wRVU

    Not priced

  • 96413

    Chemo IV infusion, initial drug, first hour0.28 wRVU

    $133.27

How to choose

J9277Pembrolizumab injectionWith hyaluronidase, per 1 mg
J9277 represents a distinct pembrolizumab-hyaluronidase product, rather than the pembrolizumab reported by J9271. Select the code matching the product administered.
J9272Dostarlimab injectionPer 10 mg
J9272 represents dostarlimab, a different anti-PD-1 drug. It is not the code for pembrolizumab.
96413Chemo IV infusionInitial drug, first hour
96413 reports an initial infusion administration service, not the drug quantity. J9271 reports the pembrolizumab quantity.

Codes related to J9271

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

Codes related to J9271
CodeHow it relatesNational office range
Used instead
J9277Pembrolizumab injection, with hyaluronidase, per 1 mgA distinct pembrolizumab-hyaluronidase product; select the code for the product administered.No office rate
J9272Dostarlimab injection, per 10 mgRepresents dostarlimab, a different anti-PD-1 drug used in cancer treatment.No office rate
Often billed with
96413Chemo IV infusion, initial drug, first hourReports initial intravenous antineoplastic infusion administration when applicable to the encounter.$114.99–$186.95

J9271 billing questions

How is J9271 different from J9277?

J9271 reports pembrolizumab. J9277 represents a distinct pembrolizumab product combined with berahyaluronidase; select the code that matches the product administered.

Does J9271 describe the infusion service?

No. J9271 reports the pembrolizumab drug quantity, not infusion duration or administration work.

How many units should be reported?

Each unit represents 1 mg of pembrolizumab. Report units based on the documented drug quantity.

Does Medicare pay J9271 under the physician fee schedule?

No. CMS assigns status E, excluding J9271 from the physician fee schedule. When covered, it is generally priced as a Part B drug using CMS quarterly ASP files.

Who determines whether Medicare covers pembrolizumab?

The Medicare contractor determines coverage for J9271.

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

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