In short

Opdualag is billed under HCPCS J9298 — Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg. One billing unit is 3 mg - 1 mg. CMS's crosswalk lists 1 Opdualag NDC under this code.

J9298 code details

Reference

J9298
Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mgBilling unit: 3 mg - 1 mg
Labelers
E.R. Squibb & Sons, L.L.C.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$205.442
Per3 mg/1 mg
Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Opdualag units and claim line

Enter the dose given to get the J9298 units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

Opdualag NDCs and billing units

From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.

Opdualag NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
00003-7125-11J9298E.R. Squibb & Sons, L.L.C.2080

Opdualag: common questions

What is the J-code for Opdualag?
Opdualag is billed under HCPCS J9298 — Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg. One billing unit is 3 mg - 1 mg. CMS's crosswalk lists 1 Opdualag NDC under this code.
How many J9298 billing units are in a package of Opdualag?
CMS lists 80 billing units per package, depending on the NDC, where one unit is 3 mg - 1 mg. Units to report are based on the dose given, not the package.
Is J9298 a CPT code?
No. J9298 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.

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