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    v1.0.30
    OpenPayerBilling CodesChemotherapy DrugsHCPCS hcpcs-j9272-dostarlimab-injection-10mg
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    HCPCS Level II J9272: Dostarlimab-gxly Injection, 10 mg

    HCPCS Level II code J9272 describes a 10 mg vial injection of dostarlimab-gxly, an intravenous monoclonal antibody used as an anti–PD-1 immunotherapy; the service is administration of the drug, typically provided in an oncology infusion setting such as an outpatient infusion center or hospital outpatient department.

    For related coverage guidance, see recent payer policy updates: T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and Romidepsin, Tumor Treatment Fields - Medical Policy, Extracorporeal Photopheresis.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with recurrent or advanced mismatch repair–deficient (dMMR) or microsatellite instability–high (MSI-H) solid tumor, such as endometrial or colorectal carcinoma, who is receiving systemic immunotherapy with dostarlimab-gxly (PD-1 inhibitor). The medication billed as J9272 (injection, dostarlimab-gxly, 10 mg) is administered by an oncology infusion nurse in an outpatient infusion center, ambulatory clinic, or hospital outpatient department. The workflow includes physician order verification, pre-infusion assessment (vital signs, review of prior infusion tolerance, laboratory checks for hepatic and renal function), preparation of the drug by pharmacy (dose calculation based on weight or fixed dosing per prescribing information), IV access placement, infusion per protocol with monitoring for infusion-related reactions and immune-related adverse events, documentation of lot number and units administered, and billing using J9272 units corresponding to milligram dose dispensed. Typical settings: outpatient oncology infusion center, hospital outpatient infusion suite, or ambulatory infusion clinic. Common clinical team members: medical oncologist, oncology pharmacist, infusion nurse, and billing/coding specialist.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    96413Chemotherapy administration, IV infusion technique; up to 1 hour, single or initial substance/drugCommon code for administration of an initial or single-agent IV infusion that may accompany J9272 when infusion duration fits the time range.
    96415Each additional hour (List separately in addition to code for primary infusion)Used when the infusion or observation extends beyond one hour and additional time-based infusion billing is appropriate.
    96417Chemotherapy administration, each additional sequential infusion of a new drug, up to 1 hourUse when multiple sequential IV drug infusions are given during the same visit in addition to the initial infusion.
    96401Chemotherapy administration, IV push, single drugApplicable if dostarlimab-gxly or supportive medications are administered as an IV push per protocol.
    36415Collection of venous blood by venipuncturePerformed for pre-infusion laboratory monitoring (e.g., CBC, CMP) and billed when separate from global services.
    96360Intravenous infusion, hydration; initial, 31 minutes to 1 hourMay be billed for concurrent hydration ordered with infusion when medically necessary.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    2085R0202X
    364S00000X
    183500000X
    261QP2300X
    207VG0400X
    246XC2901X
    2080P0204X

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    C18.9Malignant neoplasm of colon, unspecified
    C20Malignant neoplasm of rectum
    C22.0Liver cell carcinoma
    C25.9Malignant neoplasm of pancreas, unspecified
    C26.9Malignant neoplasm of ill-defined sites within the digestive system
    C34.11Malignant neoplasm of upper lobe, right bronchus or lung
    C34.12Malignant neoplasm of upper lobe, left bronchus or lung
    C34.82Malignant neoplasm of overlapping sites of left bronchus and lung
    C34.90Malignant neoplasm of unspecified part of unspecified bronchus or lung
    C41.9Malignant neoplasm of bone and articular cartilage, unspecified

    Showing 1–10 of 28

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    T-Cell Lymphoma Agents: Beleodaq, Istodax, Lymphir, Poteligeo, and RomidepsinMass General Brigham Health Plan2027-01-04
    Tumor Treatment Fields - Medical PolicyHealth-New-England2026-12-01
    Extracorporeal PhotopheresisCigna2026-11-15
    Electric Tumor Treatment Field Therapy (for Tennessee Only)Colorado Rocky Mountain Health Plans2026-11-01
    Tumor Treating Fields Therapypremerabluecrossofwashington2026-11-01
    Tumor Treating Fields Therapypremerabluecrossofwashington2026-11-01
    OmisirgeCigna2026-11-01
    Hematology - AdzynmaCigna2026-10-15
    Transcatheter Arterial Chemoembolization for Liver Tumorspremerabluecrossofwashington2026-10-01
    Cryoablation of Tumors Located in the Kidney, Lung, Breast, Pancreas, or Bonepremerabluecrossofwashington2026-10-01

    Related Codes

    HCPCS-J9000-DOXORUBICIN-10MG-INJECTION

    HCPCS J9000: Doxorubicin Hydrochloride Injection, 10 mg

    HCPCS-J9003-LEUPROLIDE-INJECTABLE-CAMCEVI-1MG

    HCPCS Level II J9003: Leuprolide injectable (camcevi etm), 1 mg

    HCPCS-J9010-ALEMTUZUMAB-INJECTION-10MG

    HCPCS Level II J9010: Injection, alemtuzumab, 10 mg

    HCPCS-J9011-DATOPOTAMAB-DERUXTECAN-INJECTION-1MG

    HCPCS J9011: Datopotamab Deruxtecan Injection, 1 mg

    HCPCS-J9015-ALDESLEUKIN-INJECTION-SINGLE-USE-VIAL

    HCPCS Level II J9015: Aldesleukin Injection, Single-Use Vial

    HCPCS-J9017-ARSENIC-TRIOXIDE-INJECTION-1MG

    HCPCS J9017: Arsenic Trioxide Injection, 1 mg

    HCPCS-J9019-ASPARAGINASE-ERWINAZE-INJECTION-1000-IU

    HCPCS Level II J9019: Asparaginase (Erwinaze) Injection, 1,000 IU

    HCPCS-J9020-ASPARAGINASE-INJECTION-10000-UNITS

    HCPCS J9020: Asparaginase Injection, 10,000 Units

    HCPCS-J9021-ASPARAGINASE-RYLAZE-INJECTION-0-1-MG

    HCPCS Level II J9021: Injection, asparaginase (Rylaze), 0.1 mg

    HCPCS-J9022-ATEZOLIZUMAB-INJECTION-10MG

    HCPCS J9022: Injection, atezolizumab 10 mg

    Showing 1–10 of 227

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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