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HCPCS J9271 (Keytruda) Fee Schedule

Last Verified: October 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Injection, pembrolizumab, 1 mg
Key FactDetail
Service Type

Chemotherapy Drugs

Common Place of Service

None

11 - Office

22 - On Campus Outpatient Hospital

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for J9271
Medicare Payment Limit
$60.291BuyandBill.com
WAC Price
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National average reimbursement for HCPCS J9271 by major payers:

bcbs

$63.71

uhc

$62.41

aetna

$65.45

cigna

$61.80

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J9271.

HCPCS J9271
5 of 25 sample ratesHigher to lower in this preview
  1. Rahul Gosain

    NYHematology & Oncology PhysicianNPI 1932455391Tax ID 16-6110402

    $78.01Published rate
  2. Brian Contreras

    Regional Employee Assistance Progra M

    TXFamily Medicine PhysicianNPI 1023571783Tax ID 76-0423386

    $62.04Published rate
  3. Faiza Tahir Md PA

    TXMulti-Specialty GroupNPI 1023656865Tax ID 46-0587961

    $58.75Published rate
  4. Todd Shenkenberg Md PA

    TXMulti-Specialty GroupNPI 1699875252Tax ID 36-4518901

    $56.41Published rate
  5. Elizabeth Sakach

    GAMedical Oncology PhysicianNPI 1629509583Tax ID 58-2030692

    $50.72Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS J9271 vs. Other Chemotherapy Drugs Codes

The HCPCS J9271 code is part of the Chemotherapy Drugs services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS J9271 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
J9271-HCPCSLowInjection, pembrolizumab, 1 mg
J9272-HCPCSModerateInjection, dostarlimab-gxly, 10 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9271. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J9271 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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