HCPCS code J9272: Dostarlimab injection, per 10 mg2026 Medicare rate & RVUs in Massachusetts
Reports dostarlimab-gxly given by intravenous infusion for certain advanced or recurrent cancers, including endometrial cancer, in oncology treatment settings.
CMS doesn’t publish an office rate for J9272 in Massachusetts.
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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What J9272 covers
Dostarlimab-gxly is an immune checkpoint inhibitor that blocks PD-1. Oncology clinicians use it in treatment regimens for certain advanced or recurrent cancers, including endometrial cancers; treatment selection may depend on tumor characteristics. It is given by intravenous infusion in settings such as hospital outpatient departments and oncology infusion centers. In some endometrial cancer regimens, it is administered with carboplatin and paclitaxel.
J9272 identifies the drug, not the infusion service, and each billing unit represents 10 mg of dostarlimab-gxly. Medicare excludes this code from the physician fee schedule under status E. When Medicare covers the drug, payment is under another method; the HCPCS pricing method identifies it as a Part B drug generally priced from CMS quarterly ASP drug files. Coverage is left to the Medicare contractor's judgment. Report the drug units based on the administered dose, and report the infusion administration separately when appropriate.
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 J9272 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | Unavailable | Unavailable |
| Rest of Massachusetts | Unavailable | Unavailable |
How the J9272 rate is calculated
Each of J9272’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 · J9272
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 J9272
J9272 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 · J9272
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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J9272 isn’t priced in this setting.
J9272 compared with similar codes
Compare codes · National
J9272 vs J9271 vs J9277: Medicare rates
How to choose
- J9271PembrolizumabPer 1 mg
- J9271 identifies pembrolizumab, not dostarlimab-gxly. Select the code for the drug actually administered.
- J9277Pembrolizumab injectionWith hyaluronidase, per 1 mg
- J9277 identifies a subcutaneous pembrolizumab product; J9272 identifies dostarlimab-gxly for intravenous administration.
J9272 billing questions
How many units should be reported?
Each unit represents 10 mg of dostarlimab-gxly. Base the units on the administered dose.
Is J9272 the infusion administration code?
No. J9272 reports the drug; the intravenous infusion administration is reported separately when appropriate, using the applicable administration code.
How does Medicare treat J9272?
CMS assigns status E, excluding the code from the physician fee schedule. When Medicare covers the drug, it pays under another method; Part B drug pricing generally uses CMS quarterly ASP files, and coverage is left to the Medicare contractor.
How is J9272 different from J9271?
J9272 is dostarlimab-gxly, while J9271 is pembrolizumab. They identify different drugs, even though both are immune checkpoint inhibitors.
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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