Cost analysis for CPT J9271 — Injection, pembrolizumab, 1 mg
Average Medicare Payment
$42.60
2023 data
Total Payments (2023)
$1.2B
Services (2023)
27.1M
Price Change (2016–2023)
+22.3%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2016 | $34.84 | $10.8M | 307.8K | — |
| 2017 | $35.79 | $53.1M | 1.5M | +2.7% |
| 2018 | $37.37 | $241.0M | 6.5M | +4.4% |
| 2019 | $37.80 | $520.2M | 13.7M | +1.2% |
| 2020 | $39.17 | $753.2M | 19.2M | +3.6% |
| 2021 | $40.69 | $874.0M | 21.4M | +3.9% |
| 2022 | $41.50 | $1.0B | 25.2M | +2.0% |
| 2023 | $42.60 | $1.2B | 27.1M | +2.7% |
The most expensive state pays 1.1x more than the cheapest for this procedure. WY averages $43.46 vs ID at $38.99.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| WY | $43.46 | $2.1M | 48.6K | 4 |
| DC | $43.39 | $2.2M | 50.2K | 2 |
| SD | $43.36 | $1.2M | 28.1K | 3 |
| MA | $43.33 | $3.3M | 76.1K | 7 |
| ME | $43.26 | $5.6M | 129.3K | 8 |
| LA | $43.24 | $4.4M | 102.8K | 7 |
| XX | $43.23 | $743.5K | 17.2K | 1 |
| KS | $43.23 | $22.0M | 509.4K | 20 |
| CT | $43.19 | $1.2M | 28.8K | 3 |
| NE | $43.17 | $18.1M | 420.0K | 27 |
| ND | $43.16 | $1.7M | 39.4K | 2 |
| DE | $43.15 | $9.9M | 230.0K | 10 |
| CO | $43.13 | $18.7M | 434.5K | 36 |
| WI | $43.10 | $3.4M | 79.9K | 9 |
| NY | $43.09 | $32.4M | 750.8K | 64 |
| TN | $43.07 | $38.0M | 882.9K | 49 |
| UT | $43.03 | $2.0M | 47.4K | 4 |
| NM | $43.02 | $5.6M | 131.0K | 12 |
| OK | $43.00 | $5.6M | 130.3K | 12 |
| VA | $42.99 | $67.8M | 1.6M | 111 |
| IN | $42.99 | $14.5M | 338.0K | 23 |
| WV | $42.97 | $1.8M | 42.9K | 2 |
| TX | $42.96 | $119.3M | 2.8M | 231 |
| VT | $42.90 | $574.9K | 13.4K | 1 |
| NJ | $42.90 | $26.7M | 622.7K | 46 |
| AR | $42.89 | $35.9M | 835.9K | 40 |
| MO | $42.87 | $22.1M | 515.2K | 44 |
| OR | $42.79 | $12.1M | 281.9K | 28 |
| NV | $42.77 | $21.9M | 512.1K | 35 |
| AZ | $42.77 | $38.5M | 900.3K | 79 |
| NC | $42.73 | $14.3M | 333.8K | 27 |
| IL | $42.71 | $60.4M | 1.4M | 107 |
| IA | $42.66 | $24.4M | 571.1K | 27 |
| AK | $42.62 | $8.5M | 200.2K | 14 |
| FL | $42.59 | $167.0M | 3.9M | 208 |
| SC | $42.41 | $25.0M | 588.5K | 30 |
| MI | $42.35 | $13.7M | 324.3K | 29 |
| MD | $42.29 | $49.6M | 1.2M | 63 |
| AL | $42.22 | $28.1M | 666.2K | 34 |
| PA | $42.21 | $24.2M | 572.8K | 40 |
| CA | $42.20 | $88.2M | 2.1M | 135 |
| GA | $42.04 | $29.2M | 693.6K | 38 |
| OH | $42.03 | $24.1M | 573.8K | 40 |
| MS | $41.88 | $12.1M | 288.0K | 12 |
| WA | $41.85 | $15.4M | 367.2K | 33 |
| MN | $41.08 | $22.3M | 543.0K | 69 |
| KY | $40.65 | $3.4M | 83.4K | 4 |
| NH | $40.02 | $3.1M | 77.0K | 7 |
| ID | $38.99 | $1.9M | 48.2K | 4 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Thomas Buroker | Medical Oncology | IA | $3.9M | 92.4K | $41.83 |
| Luke Dreisbach | Hematology-Oncology | CA | $3.7M | 84.5K | $43.26 |
| Syed Zafar | Hematology-Oncology | FL | $3.1M | 71.2K | $43.18 |
| Robert Behrens | Medical Oncology | IA | $3.0M | 70.4K | $42.28 |
| Justin Kucinski | Hematology-Oncology | MD | $3.0M | 68.8K | $42.89 |
| James Uyeki | Medical Oncology | TX | $2.9M | 67.7K | $43.22 |
| Jamal Misleh | Hematology-Oncology | DE | $2.8M | 66.0K | $43.07 |
| Mei Tang | Hematology-Oncology | MD | $2.7M | 67.6K | $39.58 |
| John Waples | Hematology-Oncology | AL | $2.5M | 56.8K | $43.20 |
| Mark Fleming | Hematology-Oncology | VA | $2.4M | 56.4K | $42.42 |
| Guangzhi Qu | Hematology-Oncology | MS | $2.4M | 55.8K | $42.62 |
| Julia Schaefer-Cutillo | Hematology-Oncology | NC | $2.3M | 55.0K | $42.50 |
| Brian Murphy | Hematology-Oncology | OH | $2.3M | 53.0K | $43.23 |
| David Smith | Hematology-Oncology | MD | $2.3M | 52.8K | $43.16 |
| Justin Baker | Hematology-Oncology | MS | $2.2M | 56.0K | $39.74 |
| Vinh-Linh Nguyen | Hematology-Oncology | CA | $2.2M | 50.8K | $43.33 |
| Steven Newman | Internal Medicine | FL | $2.2M | 50.8K | $43.18 |
| Heather Brody | Hematology-Oncology | AL | $2.1M | 49.0K | $43.28 |
| Andrew Lipman | Hematology-Oncology | FL | $2.0M | 47.0K | $42.69 |
| Vikas Malhotra | Hematology-Oncology | FL | $1.9M | 44.6K | $43.15 |
Based on the data, CPT J9271 shows a 1.1x variation in pricing across states — relatively consistent by Medicare standards.
Costs have increased 22.3% since 2016. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.