J9299 HCPCS code: Injection, nivolumab, 1 mg
J9299 is the HCPCS Level II code for injection, nivolumab, 1 mg. In 2024 Medicare paid an average of $24.25 per service for J9299 across 23,670,315 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 480 per day on outpatient hospital claims. Medicare volume fell 8% from 2022 to 2024 (25,592,086 to 23,670,315 services). In 2024, about 4,110 clinicians billed Medicare for J9299 for 10,178 beneficiaries; Florida, California, Texas accounted for 33% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1D — Chemotherapy |
| Added | 2016-01-01 |
| Last action effective | 2016-01-01 |
Who bills J9299 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 4,110 |
| Medicare beneficiaries | 10,178 |
| States with claims | 50 |
| Share of services in top 3 states (Florida, California, Texas) | 33% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9299, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 25,592,086 | 10,755 | $28.67 | $22.89 |
| 2023 | 25,078,428 | 10,670 | $29.29 | $23.33 |
| 2024 | 23,670,315 | 10,178 | $30.44 | $24.25 |
States with the most J9299 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 2,977,181 | $24.31 |
| California | 2,487,967 | $23.94 |
| Texas | 2,215,498 | $24.31 |
| Illinois | 1,068,466 | $24.40 |
| Maryland | 1,012,585 | $23.98 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 480 | Prescribing Information |
| practitioner claims | 480 | Prescribing Information |
What changed for J9299
- 2016-01-01: J9299 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 J9299?
J9299 is the HCPCS Level II code for injection, nivolumab, 1 mg. Short descriptor: "Injection, nivolumab".
How much does Medicare pay for J9299?
In 2024, the average Medicare payment was $24.25 per service (average allowed $30.44).
Does Medicare cover J9299?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J9299 can be billed per day?
480 on outpatient hospital claims; 480 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 J9299
- Watch J9299 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9299
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.