HCPCS Level II J9271: Injection, pembrolizumab, 1 mg
Commercial payers pay $313 on average nationally for this procedure.
HCPCS Level II code J9271 describes administration billing for pembrolizumab, 1 mg, recorded as an injection drug supply; the service is a systemic immunotherapy infusion/injection typically provided in oncology infusion centers or outpatient hospital infusion clinics for cancer treatment.
For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chimeric Antigen Receptor (CAR) T-Cell Therapy, Antibody-Drug Conjugates.
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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.