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

CMS doesn’t publish an office rate for J9298 in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

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 in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

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.

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.

J9298 compared with similar codes

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.

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