J9119 HCPCS code: Injection, cemiplimab-rwlc, 1 mg
J9119 is the HCPCS Level II code for injection, cemiplimab-rwlc, 1 mg. In 2024 Medicare paid an average of $21.50 per service for J9119 across 6,304,608 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 700 per day on outpatient hospital claims. Medicare volume rose 92% from 2022 to 2024 (3,275,850 to 6,304,608 services). In 2024, about 2,266 clinicians billed Medicare for J9119 for 2,690 beneficiaries; Florida, Texas, California accounted for 35% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1D — Chemotherapy |
| Added | 2019-10-01 |
| Last action effective | 2019-10-01 |
Who bills J9119 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,266 |
| Medicare beneficiaries | 2,690 |
| States with claims | 38 |
| Share of services in top 3 states (Florida, Texas, California) | 35% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9119, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 3,275,850 | 1,428 | $26.85 | $21.43 |
| 2023 | 4,951,943 | 2,187 | $26.32 | $20.97 |
| 2024 | 6,304,608 | 2,690 | $26.99 | $21.50 |
States with the most J9119 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 1,066,474 | $21.62 |
| Texas | 563,140 | $21.64 |
| California | 535,862 | $21.20 |
| Illinois | 421,750 | $21.69 |
| Tennessee | 354,203 | $21.72 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 700 | Prescribing Information |
| practitioner claims | 700 | Prescribing Information |
What changed for J9119
- 2019-10-01: J9119 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J9119?
J9119 is the HCPCS Level II code for injection, cemiplimab-rwlc, 1 mg. Short descriptor: "Inj., cemiplimab-rwlc, 1 mg".
How much does Medicare pay for J9119?
In 2024, the average Medicare payment was $21.50 per service (average allowed $26.99).
Does Medicare cover J9119?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9119 can be billed per day?
700 on outpatient hospital claims; 700 on practitioner claims (NCCI medically unlikely edits).
Related J91 codes
- J9100 — Injection, cytarabine, 100 mg
- J9118 — Injection, calaspargase pegol-mknl, 10 units
- J9120 — Injection, dactinomycin, 0.5 mg
- J9130 — Dacarbazine, 100 mg
- J9144 — Injection, daratumumab, 10 mg and hyaluronidase-fihj
- J9145 — Injection, daratumumab, 10 mg
- J9150 — Injection, daunorubicin, 10 mg
- J9151 — Injection, daunorubicin citrate, liposomal formulation, 10 mg
- J9153 — Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
- J9155 — Injection, degarelix, 1 mg
- J9160 — Injection, denileukin diftitox, 300 micrograms
- J9161 — Injection, denileukin diftitox-cxdl, 1 mcg
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Next steps
- Run a reimbursement report for a device billed under J9119
- Watch J9119 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9119
Sources: CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.