HCPCS J9271

Injection, pembrolizumab, 1 mg (CMS descriptor)

Drugs Drug code Work RVU per service none (2023 fee schedule; adds 0 work RVUs)

1,841
90th percentile among 6,405 codes billed · 2023
$1.15B
100th percentile among 6,405 codes billed · 2023
27.1M
100th percentile among 6,405 codes billed · 2023
12,400
99th percentile among 6,405 codes billed · 2023
32,601
99th percentile among 6,405 codes billed · 2023
+10.2%
Medicare payment on the code vs 2022; billers +6.5% · 2023

Trend

Medicare payment on the code

$0$500M$1.00B2020: $753M paid20202021: $874M paid20212022: $1.05B paid20222023: $1.15B paid20232024: $1.24B paid2024$1.24B$0$500M$1.00B2020: $753M paid20202021: $874M paid20212022: $1.05B paid20222023: $1.15B paid20232024: $1.24B paid2024$1.24B$0$500M$1.00B2020: $753M paid20202021: $874M paid20212022: $1.05B paid20222023: $1.15B paid20232024: $1.24B paid2024$1.24B$0$500M$1.00B2020: $753M paid20202021: $874M paid20212022: $1.05B paid20222023: $1.15B paid20232024: $1.24B paid2024$1.24B

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

01,0002,0002020: 1,467 providers20202021: 1,548 providers20212022: 1,729 providers20222023: 1,841 providers20232024: 1,922 providers20241,92201,0002,0002020: 1,467 providers20202021: 1,548 providers20212022: 1,729 providers20222023: 1,841 providers20232024: 1,922 providers20241,92201,0002,0002020: 1,467 providers20202021: 1,548 providers20212022: 1,729 providers20222023: 1,841 providers20232024: 1,922 providers20241,92201,0002,0002020: 1,467 providers20202021: 1,548 providers20212022: 1,729 providers20222023: 1,841 providers20232024: 1,922 providers20241,922

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
20241,922$1,242,513,566+8%28,218,85612,40031,4000.00
20231,841$1,154,350,197+10%27,083,04512,40032,6010.00
20221,729$1,047,455,630+20%25,195,37212,40031,6000.00
20211,548$874,037,553+16%21,421,85511,60030,2600.00
20201,467$753,229,592first year in data19,161,47910,83028,9400.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
Florida208$166,966,6563,920,71516,10037,800
Texas231$119,309,4912,777,11610,70023,050
California135$88,219,1832,090,53813,10032,590
Virginia111$67,815,2831,577,45712,80028,350
Illinois107$60,365,3231,413,51211,60027,800
Maryland63$49,617,4041,173,28815,00038,360
Arizona79$38,507,287900,34410,00023,613
Tennessee49$38,030,762882,90017,40033,960
Arkansas40$35,852,092835,90020,70035,410
New York64$32,353,195750,8289,90024,763
Georgia38$29,155,950693,60315,20033,690
Alabama34$28,126,405666,20419,90040,940
New Jersey46$26,714,279622,72510,65032,150
South Carolina30$24,958,729588,45719,70029,630
Iowa27$24,362,032571,10017,20060,260

Not listed: 1 billers with an armed-forces or unknown state code (XX); they are in the national totals.

Not listed: 16 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2023.

Top metro areas

observed calculated calculated calculated calculated
Dallas-Fort Worth-Arlington, TX93$41,650,169968,90010,000
Chicago-Naperville-Elgin, IL-IN73$40,679,364945,8359,200
New York-Newark-Jersey City, NY-NJ67$36,580,000849,93410,000
Washington-Arlington-Alexandria, DC-VA-MD-WV62$33,448,161791,62411,500
Virginia Beach-Chesapeake-Norfolk, VA-NC35$29,305,851681,60216,000
Phoenix-Mesa-Chandler, AZ59$26,684,343620,88910,000
Los Angeles-Long Beach-Anaheim, CA46$26,500,711646,58112,650
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD32$24,738,166578,00016,000
Baltimore-Columbia-Towson, MD28$23,481,518552,06815,210
Little Rock-North Little Rock-Conway, AR19$20,059,932467,20024,400
Austin-Round Rock-San Marcos, TX31$19,820,021459,00311,800
Cape Coral-Fort Myers, FL19$19,393,663451,90121,400
North Port-Bradenton-Sarasota, FL24$19,101,179458,88017,700
Las Vegas-Henderson-North Las Vegas, NV28$17,784,161416,48612,900
Memphis, TN-MS-AR19$17,561,640408,10021,100

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 47 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing J9271 nationally

Hematology-Oncology accounts for 70% of payment for J9271 nationally in 2023, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Hematology-Oncology1,23967%$813,544,84670%19,099,97515,416
Medical Oncology45425%$265,751,86023%6,228,83713,720
Internal Medicine593.2%$33,231,6852.9%775,79113,149
Hematology281.5%$15,387,9161.3%362,44012,944
Nurse Practitioner201.1%$8,429,9610.73%196,2179,811
Gynecological Oncology201.1%$8,381,4540.73%194,5759,729

Not listed: 5 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2023.

Top billers of J9271 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations