HCPCS code J9999: Antineoplastic drug, not otherwise classified2026 Medicare rate & RVUs

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

What J9999 covers

J9999 is the HCPCS Level II not-otherwise-classified code for antineoplastic drugs without a more specific HCPCS code. It represents a drug category, not a named medication. When a drug-specific HCPCS code describes the antineoplastic drug, that code identifies the medication; J9999 is used for an antineoplastic drug that lacks such a specific code. Claims should identify the actual medication and amount administered so the reported NOC drug can be understood.

CMS assigns J9999 physician fee schedule status E, excluding it from the physician fee schedule. When Medicare covers the item or service, payment is made under another payment method. For a covered Part B drug, Medicare generally pays using CMS's quarterly Average Sales Price drug pricing files. Special Medicare coverage instructions apply to this code.

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 J9999 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

J9999 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the J9999 rate is calculated

Each of J9999’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 J9999

J9999 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.

J9999 compared with similar codes

How to choose

J3490Unclassified drugNo drug-specific code

J3490 is the general unclassified-drug code. J9999 is specifically for antineoplastic drugs that lack a more specific HCPCS code.

J9171Docetaxel injectionPer 1 mg

J9171 identifies docetaxel with a drug-specific code. Use J9999 only when the antineoplastic drug lacks a more specific HCPCS code.

J9201Gemcitabine injectionPer 200 mg

J9201 identifies gemcitabine with a drug-specific code. J9999 is the NOC option when no specific code describes the antineoplastic drug.

Codes related to J9999

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