J9298 HCPCS code: Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg
J9298 is the HCPCS Level II code for injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg. In 2024 Medicare paid an average of $145.80 per service for J9298 across 687,733 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 160 per day on outpatient hospital claims. Medicare volume rose 789% from 2022 to 2024 (77,378 to 687,733 services). In 2024, about 1,009 clinicians billed Medicare for J9298 for 875 beneficiaries; Florida, California, Texas accounted for 41% 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 | 2022-10-01 |
| Last action effective | 2022-10-01 |
Who bills J9298 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,009 |
| Medicare beneficiaries | 875 |
| States with claims | 24 |
| Share of services in top 3 states (Florida, California, Texas) | 41% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9298, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 77,378 | 220 | $174.39 | $138.96 |
| 2023 | 519,744 | 713 | $177.78 | $141.64 |
| 2024 | 687,733 | 875 | $183.00 | $145.80 |
States with the most J9298 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 108,040 | $145.84 |
| California | 88,951 | $145.74 |
| Texas | 61,760 | $147.56 |
| Maryland | 45,670 | $134.63 |
| Tennessee | 31,681 | $147.97 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 160 | Prescribing Information |
| practitioner claims | 160 | Prescribing Information |
What changed for J9298
- 2022-10-01: J9298 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 J9298?
J9298 is the HCPCS Level II code for injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg. Short descriptor: "Inj nivol relatlimab 3mg/1mg".
How much does Medicare pay for J9298?
In 2024, the average Medicare payment was $145.80 per service (average allowed $183.00).
Does Medicare cover J9298?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9298 can be billed per day?
160 on outpatient hospital claims; 160 on practitioner claims (NCCI medically unlikely edits).
Related J92 codes
- J9200 — Injection, floxuridine, 500 mg
- J9201 — Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg
- J9202 — Goserelin acetate implant, per 3.6 mg
- J9203 — Injection, gemtuzumab ozogamicin, 0.1 mg
- J9204 — Injection, mogamulizumab-kpkc, 1 mg
- J9205 — Injection, irinotecan liposome, 1 mg
- J9206 — Injection, irinotecan, 20 mg
- J9207 — Injection, ixabepilone, 1 mg
- J9208 — Injection, ifosfamide, 1 gram
- J9209 — Injection, mesna, 200 mg
- J9210 — Injection, emapalumab-lzsg, 1 mg
- J9211 — Injection, idarubicin hydrochloride, 5 mg
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Next steps
- Run a reimbursement report for a device billed under J9298
- Watch J9298 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9298
Sources: CMS HCPCS Level II release October 2025; 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.