FeeBase
Log inGet started
Menu

HCPCS code J9298: Nivolumab-relatlimab, per 3 mg/1 mg2026 Medicare rate & RVUs

This code reports the nivolumab-relatlimab combination administered by intravenous infusion, commonly for unresectable or metastatic melanoma.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J9298

Nivolumab-relatlimab, per 3 mg/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 J9298 →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 J9298 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 J9298 covers

J9298 identifies the combination of nivolumab and relatlimab-rmbw, marketed as Opdualag. Oncology practices and hospital infusion departments typically report it when administering the combination by intravenous infusion for unresectable or metastatic melanoma. The drug combines immune checkpoint inhibitors; the code represents the medication, not the infusion service.

CMS assigns J9298 physician fee schedule status E, meaning it is excluded from the physician fee schedule. When Medicare covers the drug, payment is through another method; HCPCS pricing identifies it as a Part B drug generally priced from CMS quarterly Average Sales Price files. Coverage is left to the Medicare contractor’s judgment. One billing unit represents 3 mg of nivolumab and 1 mg of relatlimab. Report units based on the amounts administered, and report the infusion administration separately when applicable.

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 J9298 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

J9298 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

J9298 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
J9298 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 J9298 rate is calculated

Each of J9298’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 · J9298

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 J9298

J9298 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 · J9298

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

J9298 isn’t priced in this setting.

J9298 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • J9298

    Nivolumab-relatlimab, per 3 mg/1 mg0 wRVU

    Not priced

  • J9299

    Nivolumab, per 1 mg0 wRVU

    Not priced

  • J9289

    Nivolumab-hyaluronidase, per 2 mg0 wRVU

    Not priced

  • J9271

    Pembrolizumab, per 1 mg0 wRVU

    Not priced

How to choose

J9299NivolumabPer 1 mg
J9299 is for nivolumab alone. J9298 is for the fixed combination of nivolumab and relatlimab.
J9289Nivolumab-hyaluronidasePer 2 mg
J9289 identifies a nivolumab-hyaluronidase product for subcutaneous administration; J9298 identifies the nivolumab-relatlimab combination for intravenous infusion.
J9271PembrolizumabPer 1 mg
J9271 is pembrolizumab, a different drug. Report the code for the specific product administered, not J9298 based only on a melanoma diagnosis.

Codes related to J9298

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

Codes related to J9298
CodeHow it relatesNational office range
Often billed with
96413Chemo IV infusion, initial drug, first hourCommonly reports the initial infusion administration service when separately reportable.$114.99–$186.95
Used instead
J9299Nivolumab, per 1 mgIdentifies nivolumab alone when that product, rather than the combination, is administered.No office rate
J9271Pembrolizumab, per 1 mgIdentifies pembrolizumab, a distinct checkpoint inhibitor used in melanoma treatment.No office rate

J9298 billing questions

How many milligrams are represented by one unit?

One unit represents 3 mg of nivolumab and 1 mg of relatlimab. Determine the reported units from the amounts administered.

Does J9298 include the infusion administration?

No. J9298 identifies the combination drug; the infusion service is separate when reportable. CPT 96413 is commonly used for the initial infusion service.

When should J9299 be used instead?

J9299 identifies nivolumab without relatlimab. Use the code matching the product actually administered; J9298 is for the nivolumab-relatlimab combination.

Does Medicare cover J9298 automatically?

No. CMS leaves coverage to the Medicare contractor’s judgment. When covered, the drug is paid under another payment method rather than the physician fee schedule.

What should the drug documentation support?

Document the nivolumab-relatlimab product administered and the amounts of both ingredients given, so the billed units reflect the combination dose.

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

Did this answer your question about what J9298 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put J9298 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist