HCPCS code J9299: Nivolumab, per 1 mg2026 Medicare rate & RVUs in Illinois
Reports nivolumab, an intravenous cancer immunotherapy, by the milligram administered when treatment uses nivolumab alone.
CMS doesn’t publish an office rate for J9299 in Illinois.
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 J9299 covers
Nivolumab is an immune checkpoint inhibitor used to treat several cancers, including melanoma, lung cancer, kidney cancer, and certain lymphomas. Oncology practices and hospital cancer departments typically report it when administering the drug by intravenous infusion as part of a cancer treatment plan. This code identifies nivolumab alone, not the nivolumab-relatlimab combination or a subcutaneous nivolumab formulation.
Medicare assigns this HCPCS code physician fee schedule status E, which excludes it from the physician fee schedule. When Medicare covers the drug, payment is made under another payment method; CMS generally prices covered Part B drugs using its quarterly Average Sales Price drug pricing files. The HCPCS coverage code indicates that special Medicare coverage instructions apply. One unit represents 1 mg, so a 240 mg administered dose corresponds to 240 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 J9299 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | Unavailable |
| East St. Louis, IL | Unavailable | Unavailable |
| Rest of Illinois | Unavailable | Unavailable |
| Suburban Chicago, IL | Unavailable | Unavailable |
How the J9299 rate is calculated
Each of J9299’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 · J9299
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 J9299
J9299 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 · J9299
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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J9299 isn’t priced in this setting.
J9299 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- J9289Nivolumab-hyaluronidasePer 2 mg
- Use J9299 for nivolumab alone in 1 mg units. J9289 identifies a hyaluronidase-containing nivolumab formulation and uses 2 mg units.
- J9298Nivolumab-relatlimabPer 3 mg/1 mg
- J9298 identifies the nivolumab-relatlimab combination. J9299 identifies nivolumab alone.
- J9271PembrolizumabPer 1 mg
- J9271 represents pembrolizumab, a different immunotherapy drug. Do not use it to report nivolumab.
J9299 billing questions
How is J9299 different from J9289?
J9299 represents nivolumab alone for intravenous use, in 1 mg units. J9289 represents a different nivolumab formulation paired with hyaluronidase and is reported in 2 mg units.
How many units should be reported?
Report one unit for each 1 mg of nivolumab administered. For example, a 240 mg dose is 240 units.
Does J9299 include the infusion service?
J9299 identifies the drug, not the work of administering an intravenous infusion. Report the applicable administration service separately when supported by the encounter.
How does Medicare treat J9299?
CMS assigns status E, excluding the code from the physician fee schedule. When Medicare covers the drug, it pays under another payment method and generally uses its quarterly ASP drug pricing files for Part B drug pricing.
What documentation supports the reported units?
Document the nivolumab dose administered and the drug administration record. Calculate units from the dose in milligrams because each unit represents 1 mg.
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
Fee sheets · Coming soon
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