HCPCS code J9280: Mitomycin injection, per 5 mg2026 Medicare rate & RVUs in Maryland
Reports injectable mitomycin used in cancer treatment, with each HCPCS unit representing 5 mg of the drug.
CMS doesn’t publish an office rate for J9280 in Maryland.
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 J9280 covers
Mitomycin is an antineoplastic drug used in cancer treatment and is typically administered intravenously. Oncology clinicians administer it in hospital outpatient departments, infusion centers, or physician offices. The treating practitioner or facility reports the drug based on the amount administered. A chemotherapy administration service is reported separately when appropriate to the documented administration method.
CMS assigns J9280 physician fee schedule status E, excluding it from the physician fee schedule. When Medicare covers the drug, payment is made under another payment method. CMS classifies it as a Part B drug that is generally priced using the quarterly Average Sales Price drug pricing files. Medicare coverage is subject to special coverage instructions. One unit represents 5 mg, so a documented 20 mg dose represents 4 units.
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 J9280 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | Unavailable |
| Rest of Maryland | Unavailable | Unavailable |
| Washington, DC area | Unavailable | Unavailable |
How the J9280 rate is calculated
Each of J9280’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 · J9280
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 J9280
J9280 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 · J9280
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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J9280 isn’t priced in this setting.
J9280 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- J9281Mitomycin instillationPer 1 mg
- J9281 identifies a mitomycin instillation form. J9280 identifies injectable mitomycin; distinguish them by the form administered.
- J9282Mitomycin instillationIntravesical, per 1 mg
- J9282 identifies intravesical mitomycin instillation. Use J9280 for injectable mitomycin rather than the intravesical instillation form.
- J9293Mitoxantrone injectionPer 5 mg
- J9293 identifies mitoxantrone hydrochloride, a different antineoplastic drug. Similar code numbering and a 5 mg unit do not make it interchangeable with mitomycin.
J9280 billing questions
How many units should be reported?
Each unit represents 5 mg of mitomycin. Divide the documented amount administered by 5 mg; for example, 20 mg is 4 units.
When should J9280 be used instead of J9281 or J9282?
J9280 identifies injectable mitomycin. J9281 and J9282 identify mitomycin instillation forms, with J9282 specifically identifying intravesical instillation; select the code that matches the form administered.
Is the chemotherapy administration service included in J9280?
J9280 reports the drug, not the administration service. A separately reportable chemotherapy administration service depends on the documented administration method.
Does Medicare pay J9280 under the physician fee schedule?
No. CMS assigns status E, excluding J9280 from the physician fee schedule; when Medicare covers the drug, it pays under another method.
How does Medicare price the drug when it is covered?
CMS classifies J9280 as a Part B drug that is generally priced using its quarterly Average Sales Price drug pricing files. Medicare coverage is subject to special coverage instructions.
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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