HCPCS code J9999: Antineoplastic drug, not otherwise classified2026 Medicare rate & RVUs in Guam
J9999 reports an antineoplastic drug lacking a specific HCPCS code; covered Part B drugs generally use CMS quarterly ASP drug pricing files.
CMS doesn’t publish an office rate for J9999 in Guam.
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 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.
J9999 in Hawaii, Guam, HI
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam, HI | Unavailable | Unavailable |
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.
How the rate is built · J9999
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 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.
Place of service · J9999
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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J9999 isn’t priced in this setting.
J9999 compared with similar codes
Compare codes · National
4 codes, side by side
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.
J9999 billing questions
When should a biller use J9999 instead of a drug-specific code?
Use J9999 when the antineoplastic drug does not have a more specific HCPCS drug code. If a specific code describes the drug, report that code instead.
How does J9999 differ from J3490?
J3490 is the general unclassified-drug code, while J9999 is for antineoplastic drugs not otherwise classified. Select the code that fits the medication and its classification.
What should the claim show about the administered drug?
Identify the actual antineoplastic medication and the amount administered. J9999 identifies the NOC category, not a named medication.
How does Medicare treat J9999?
CMS assigns status E, excluding it from the physician fee schedule. When Medicare covers a Part B drug, it generally pays using CMS's quarterly ASP drug pricing files.
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
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