CareCost Vials
2 × 100 mg
1 billing unit = 1 mg
200 mg dose → 200 billing units
J9271 · pembrolizumab
100 mg/4 mL single-dose vial · JZ when nothing is discarded
Calculate this patient's units ↓200 mg every 3 weeks · 400 mg every 6 weeks
Your Keytruda dose and 200 billing units carry straight into the estimate.
Pick the payer, enter what the patient has already met toward the deductible and the out-of-pocket maximum, and choose a copay program. CareCost returns the patient's share as a good faith estimate you can hand over.
Patient owes, 200 mg
Change the payer and the estimate re-prices against that payer's own published rate. The result is a good faith estimate for the patient.
J9271 bills 1 mg per unit: ordered dose ÷ 1 mg = billing units. A 200 mg dose is 200 units; a 400 mg dose is 400 units. The standard adult schedule needs no rounding and no per-kilogram multiplication, because the adult dose is a flat 200 mg or 400 mg regardless of weight or indication.
Keytruda ships as a 100 mg/4 mL single-dose vial, so the 200 mg dose draws two vials and the 400 mg dose draws four — both divide evenly with nothing left over, which is why JZ (no drug discarded) is the modifier on virtually every adult claim. Only the pediatric weight-based dose (2 mg/kg, capped at 200 mg) can land between vial sizes and produce a JW waste line.
Medicare pays $60.645 per mg (ASP+6%), effective for claims in Q3 2026 — $12,129.00
for the 200-unit example above.
| Dose | Billing units | Vials | Modifier |
|---|---|---|---|
| 100 mg | 100 | 1 × 100 mg | JZ |
| 200 mg (standard adult, q3w) | 200 | 2 × 100 mg | JZ |
| 300 mg | 300 | 3 × 100 mg | JZ |
| 400 mg (extended interval, q6w) | 400 | 4 × 100 mg | JZ |
| Pediatric, 30 kg × 2 mg/kg = 60 mg | 60 | 1 × 100 mg | JW (40 mg discarded) |
| Pediatric, 90 kg × 2 mg/kg = 180 mg | 180 | 2 × 100 mg | JW (20 mg discarded) |
| Pediatric, 100 kg+ (capped at 200 mg) | 200 | 2 × 100 mg | JZ |
JZ — no discarded drug from a single-dose container. JW — discarded drug from a single-dose container, reported on its own claim line. One of the two is required on every J9271 claim per CMS's July 1, 2023 single-dose container policy.
J9271 × 200 JZ · 96413 × 1. The same is true for the 400 mg dose (4 vials,
0 waste) — JZ is the norm on virtually every adult Keytruda claim.
J9271 × 60 · J9271 × 40 JW · 96413 × 1.
96413 covers the initial hour of a chemotherapy or complex-biologic infusion. A standard Keytruda infusion runs 30 minutes and fits inside that window, so bill 96413 alone — the add-on code 96415 (each additional hour) does not apply unless a combination regimen pushes total chair time past one hour. The subcutaneous sibling, Keytruda Qlex, takes 1–2 minutes to administer and bills a different code, 96401.
Keytruda IV ships in one size: a 100 mg/4 mL single-dose solution vial. J9271 (“Injection, pembrolizumab, 1 mg”) is the only HCPCS code for Keytruda IV, in effect since January 1, 2016. The subcutaneous sibling, Keytruda Qlex (pembrolizumab and berahyaluronidase alfa), is a separate product with its own code, J9277, and its own 395 mg and 790 mg single-dose vials — it is not a biosimilar and cannot be billed under J9271. Qlex bills fixed doses (395 mg q3w or 790 mg q6w) instead of the 200/400 mg IV schedule, so its unit math and admin code (96401) differ from this page. See the FDA Keytruda label (BLA 125514) for full dosing and administration instructions, or the current Medicare rate for J9271 →.
200 billing units. Keytruda J9271 bills 1 unit per 1 mg, so the dose in mg and the unit count are always the same number.
400 billing units.
J9271 for the IV formulation. The subcutaneous sibling, Keytruda Qlex, bills under its own code, J9277.
JZ on virtually every adult claim — the 200 mg and 400 mg doses divide evenly into 100 mg vials with no waste. JW only comes up with pediatric weight-based dosing, where the calculated dose rarely fills a whole vial.
Billing 2 units because the dose used 2 vials. J9271 is 1 mg per unit, not 1 vial per unit, so a 200 mg dose is 200 units — billing 2 units instead pays $121.29 rather than $12,129.00.
96413 alone. A standard Keytruda infusion runs 30 minutes, which fits inside the single-hour 96413 window, so the add-on code 96415 (each additional hour) does not apply.
CareCost combines drug units, the payer's allowed rate, plan benefits, and available financial assistance into one owed-amount total. Calculate this patient's estimate →
$60.645 per mg (ASP+6%), effective for claims in Q3 2026 — $12,129.00 for a 200 mg dose.
Data current: pricing Q3 2026
Sources: CMS ASP pricing files (Q3 2026); FDA-approved prescribing information (KEYTRUDA label, revised July 2026, BLA 125514; KEYTRUDA QLEX label, BLA 761467); CMS single-dose container JW/JZ policy (effective July 1, 2023); CPT codebook administration-code guidance; 37 commercial payer medical policies verified May 2026.
Reviewed September 9, 2026 by Erin Rose, CareCost Estimate founder. Methodology →