HCPCS J9271: Injection, Pembrolizumab, 1 mg
HCPCS Level II code J9271 represents pembrolizumab billed per 1 mg for physician-administered immunotherapy. Pembrolizumab is an immune checkpoint inhibitor used across multiple oncology indications; reporting by milligram enables precise capture of administered drug units for high-cost biologic therapies. Nationally, accurate reporting of HCPCS drug J-codes influences pharmacy and medical benefit coordination, claims adjudication, and cost transparency for oncology care.
This analysis covers major payers including Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of coverage considerations and common clinical administration pairings, plus context on how J9271 is used with chemotherapy infusion services and related infusion procedure codes. The publication outlines benchmarks and coding associations relevant to oncology service lines, highlights typical sites of service for pembrolizumab administration, and lists clinically related administration CPT codes used alongside the drug code.
Content provides a concise reference for revenue cycle, oncology clinicians, and policy staff seeking to understand billing classification and clinical context for pembrolizumab reporting at the national level. Data not available in the input is noted where applicable.
Customize your policy alerts
Sign up for hcpcs J9271 policy alerts
Get alerted when payer policies referencing J9271 are released or updated.
Monitor payer policy activity
Billing Code Overview
HCPCS Level II code J9271 describes Injection, pembrolizumab, 1 mg. This code represents the billed drug product for pembrolizumab measured per milligram and is used when reporting administration of the medication itself. The service type is a physician-administered antineoplastic/immunotherapy drug delivered by injection. The typical site of service is outpatient infusion centers or hospital outpatient departments where intravenous or subcutaneous antineoplastic therapies are administered.
National Reimbursement Benchmarks
Commercial market rates for HCPCS J9271 vary notably around the BUCA average commercial mean of $313.40. Blue Cross Blue Shield centers its distribution with a tight interquartile spread (P75–P25 = $3.40), while Cigna ($6.30 range) and UnitedHealth Group ($6.90 range) show modestly wider but still concentrated IQRs. Aetna displays extreme dispersion; its P25–P75 spread is $33.00 and its overall max is an outlier at $31,239.20, indicating substantial upward skew in some contracted rates.
Across payers, Blue Cross Blue Shield is the tightest in the middle 50% of claims, followed by Cigna and UnitedHealth Group. BUCA’s mean at $313.40 sits well above the other commercial medians near $60, reflecting that BUCA’s average commercial reimbursement is materially higher than the typical payer median. Aetna’s IQR and maximum create the widest variability among the listed commercial payers.