RxDoctor Payments Data

HCPCS J9271

Injection, pembrolizumab, 1 mg

$55.27Medicare-allowed amount per service, averaged across 28,218,856 services
Providers submitted
$136.94

Asking price, not received

Medicare allowed
$55.27

The fee schedule figure

Medicare paid
$44.03

Balance is patient coinsurance

Providers submitted an average of $136.94 for this code and Medicare allowed $55.272.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $44.03 (80%); the rest is the patient’s coinsurance and deductible.

Services
28,218,856

Medicare Part B, 2024

Beneficiaries
40,976
Providers billing it
1,922
Total allowed
$1,559,656,171

Services × allowed amount

What Medicare pays for HCPCS J9271

Across 28,218,856 services billed by 1,922 providers to 40,976 beneficiaries, Medicare allowed an average of $55.27 per service. That is 688.7 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills J9271

SpecialtyServicesBeneficiariesAvg allowedProviders
Hematology-Oncology20,244,17928,419$55.331,314
Medical Oncology5,975,5779,302$55.17438
Internal Medicine847,2661,339$55.4062
Hematology351,664506$55.3322
Gynecological Oncology256,370327$51.4821
Nurse Practitioner233,500455$55.8531
Physician Assistant165,700280$55.7317
Hospitalist48,10072$56.103
Hematopoietic Cell Transplantation and Cellular Therapy37,400152$52.575
Obstetrics & Gynecology15,30025$56.212
Surgical Oncology13,20017$57.531
Radiation Oncology10,00026$56.352
Hospice and Palliative Care10,00030$56.262
Urology6,80011$56.181
Rheumatology3,80015$55.801

J9271 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
Florida3,896,166$54.87$43.84220
Texas2,835,551$55.77$44.70234
California2,503,592$54.73$43.64164
Illinois1,469,521$55.34$44.36105
Virginia1,452,007$55.50$44.82109
Maryland1,240,737$55.13$44.2669
Arizona1,081,288$55.49$44.3393
Tennessee1,022,100$55.80$44.7461
Arkansas938,900$55.76$44.5441
Pennsylvania838,564$55.06$44.1253
Alabama801,839$55.25$44.3543
New York730,694$55.94$44.6767
Georgia667,224$54.57$44.2036
South Carolina644,161$55.53$44.4035
New Jersey643,501$55.76$44.4545
Iowa613,050$54.64$43.7326
Ohio602,902$54.27$43.3845
Minnesota571,456$53.19$42.8268
Kansas561,700$55.99$44.6719
Nevada489,516$55.04$44.6833
Colorado457,200$55.86$44.6939
Nebraska442,644$55.94$44.6429
Washington337,309$55.41$44.4630
Missouri307,360$55.73$44.6525
Mississippi305,000$54.41$45.0015
Oregon289,209$55.93$44.6629
North Carolina285,309$55.31$44.8526
Michigan266,000$55.59$44.5125
Indiana254,917$55.89$44.6420
Alaska187,400$55.97$44.6712
Oklahoma162,700$55.82$44.7514
Wisconsin151,402$55.90$44.5414
Delaware149,200$55.79$44.698
New Mexico142,000$55.89$44.5112
Maine127,400$56.02$44.707
Kentucky103,821$55.17$44.337
Louisiana95,200$56.12$44.695
New Hampshire63,001$53.77$42.995
Idaho60,300$54.53$43.755
South Dakota59,700$55.67$44.533
Massachusetts56,600$55.23$44.035
Vermont53,600$55.44$44.173
Utah51,414$56.12$44.703
Wyoming49,000$55.97$44.592
North Dakota45,031$56.04$44.642
Connecticut34,300$55.78$44.773
West Virginia21,812$55.62$44.322
XX15,800$56.08$44.681
District of Columbia11,150$55.54$44.251
Rhode Island10,600$54.83$43.652
Guam10,000$55.28$45.001
Hawaii8,008$56.43$44.961

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.