HCPCS code J9271: Pembrolizumab, per 1 mg2026 Medicare rate & RVUs in Texas
Reports pembrolizumab quantity in 1 mg units for cancer immunotherapy, commonly administered by intravenous infusion in oncology clinics and hospital settings.
CMS doesn’t publish an office rate for J9271 in Texas.
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 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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | Unavailable |
| Beaumont, TX | Unavailable | Unavailable |
| Brazoria, TX | Unavailable | Unavailable |
| Dallas, TX | Unavailable | Unavailable |
| Fort Worth, TX | Unavailable | Unavailable |
| Galveston, TX | Unavailable | Unavailable |
| Houston, TX | Unavailable | Unavailable |
| Rest of Texas | Unavailable | Unavailable |
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
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
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J9271 isn’t priced in this setting.
J9271 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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