HCPCS code J9281: Mitomycin instillation, per 1 mg2026 Medicare rate & RVUs in Michigan
Mitomycin is instilled into the renal pelvis and calyces for upper-tract urothelial tumors, with units based on the amount of drug administered.
CMS doesn’t publish an office rate for J9281 in Michigan.
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 J9281 covers
J9281 identifies mitomycin instilled into the renal pelvis and calyces, the collecting spaces of the upper urinary tract. Urologists use this local chemotherapy for upper-tract urothelial tumors. Delivery may use a ureteral catheter or nephrostomy tube. The code represents the drug amount, not the access service, and differs from mitomycin injection and bladder instillation codes.
CMS assigns status E, excluding J9281 from the physician fee schedule. When Medicare covers the drug, payment is under another method; the HCPCS file classifies it as a Part B drug, generally priced from CMS quarterly ASP drug pricing files. Coverage is left to the Medicare contractor's judgment. Report units based on mitomycin quantity: one unit represents 1 mg.
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 J9281 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | Unavailable |
| Rest of Michigan | Unavailable | Unavailable |
How the J9281 rate is calculated
Each of J9281’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 · J9281
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 J9281
J9281 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 · J9281
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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J9281 isn’t priced in this setting.
J9281 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- J9282Mitomycin instillationIntravesical, per 1 mg
- Choose J9281 for renal pelvis and calyces instillation and J9282 for bladder instillation.
- J9280Mitomycin injectionPer 5 mg
- J9280 identifies mitomycin injection; J9281 identifies mitomycin instilled into the renal pelvis and calyces.
- 50391Renal instillationThrough nephrostomy access
- CPT 50391 describes therapeutic-agent instillation through a nephrostomy tube; J9281 represents the mitomycin drug quantity.
J9281 billing questions
When should J9281 be used instead of J9282?
J9281 is for mitomycin instilled into the renal pelvis and calyces. J9282 identifies mitomycin instilled into the bladder.
How many units should be reported?
Each J9281 unit represents 1 mg of mitomycin. Base the units on the amount of drug administered.
Does J9281 describe the instillation procedure?
J9281 represents the mitomycin drug quantity, not the access service. CPT 50391 describes therapeutic-agent instillation through a nephrostomy tube.
How does Medicare treat J9281?
CMS assigns status E, excluding J9281 from the physician fee schedule. When covered, it is classified as a Part B drug generally priced using quarterly CMS ASP files; coverage is left to the Medicare contractor's judgment.
Is J9281 the code for mitomycin injection?
No. J9281 is for instillation into the renal pelvis and calyces; J9280 identifies mitomycin injection.
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.
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