HCPCS code J9299 — Injection, nivolumab.
Status: Active.
Effective Jan 1, 2016.
Source: CMS HCPCS Level II.
J9299
ActiveInjection, nivolumab
Injection, nivolumab, 1 mg
Category:
Drugs
Section:
J-codes: Drugs Administered Other Than Oral Method
Effective:
Jan 1, 2016
Code type:
alphanumeric
OPPS Status:
K
— Non-pass-through drugs and biologicals
OPPS APC:
9453
Drug class:
Anti-PD-1 Checkpoint Inhibitors
Medicare Part B utilization — 2023
Services billed
1,320,000
Beneficiaries
92,000
Medicare paid
$337,920,000
Avg per service
$320.00
Source: Medicare Part B Provider Utilization Public Use File (anonymized, aggregated to HCPCS level).
MUE — Medically Unlikely Edits
Maximum units of J9299 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| DME Supplier | 0 |
| Outpatient Hospital | 480 |
| Practitioner Services | 480 |
Source: CMS Medicare NCCI Medically Unlikely Edits
NDC Crosswalk
National Drug Codes (NDCs) mapped to this HCPCS code.
| NDC | Drug Name |
|---|---|
| 00003-3734-13 | Opdivo |
| 00003-3756-14 | Opdivo |
| 00003-3772-11 | Opdivo |
| 00003-3774-12 | Opdivo |