OPDUALAG J Code: J9298

Drug & Product Overview

HCPCS Descriptor Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg

HCPCS Added Date October 1, 2022

Manufacturer BMS

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection

About OPDUALAG

Opdualag is a medication aligned to the HCPCS J Code: J9298 for billing, pricing, and reimbursement purposes in the United States. It is an Oncology drug administered via the intravenous route and manufactured by BMS.

According to CMS Drug Use Information: This product contains 2 medications: nivolumab and relatlimab. Nivolumab/relatlimab is used to treat a certain type of skin cancer (melanoma). It works by changing the action of your own immune system, directing it to attack cancer cells. Nivolumab and relatlimab belong to a class of drugs known as monoclonal antibodies.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
00003-7125-11	Opdualag	E.R. Squibb & Sons, L.L.C.	80	240 MG / 20 ML

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OPDUALAG Pricing & Reimbursement

J9298 Private Payer Reimbursement

$208.11 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

OPDUALAG Claims Performance

Claims from Jan 2026 – Aug 2026

Claim Denial Rate 8.86%

Avg. Days to File 6.8days

Avg. Days to Pay 24.1days

Real-world claims performance from FocalPoint, OnPoint Oncology's reimbursement analytics platform, with claims data accrued at the clearing house level.

Explore J9298 claims analytics on FocalPoint →

OPDUALAG CPT Administration Codes

CPT Code	Description
96413	Chemotherapy administration, intravenous infusion technique; up to 1 hour, single or initial substance/drug
96415	Chemotherapy administration, intravenous infusion technique; each additional hour (List separately in addition to code for primary procedure)

JW / JZ modifiers apply

CMS has identified Opdualag (J9298) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

OPDUALAG Medically Unlikely Edits (MUE)

The most billing units of J9298 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 3 mg - 1 mg.

Practitioner Office & Hospital Outpatient

160 units / day

= 480 mg - 1 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

OPDUALAG Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Unresectable or metastatic melanoma

Drug Class

Lymphocyte Activation Gene-3 Antagonists [MoA]Lymphocyte Activation Gene-3 Blocker [EPC]Programmed Death Receptor-1 Blocking Antibody [EPC]Programmed Death Receptor-1-directed Antibody Interactions [MoA]

Frequently Asked Questions

Is there an available Opdualag billing and coding guide?

Billing and coding information for OPDUALAG can be found through BMS. Visit Here →

Are there any available Opdualag patient assistance programs?

OPDUALAG patient assistance information can be found through Bristol Myers Squibb. Visit Here →

Where can I find Opdualag prescribing information?

OPDUALAG prescribing information can be found at the link below: Visit Here →

Where can I find Opdualag side effect information?

Information regarding OPDUALAG's side effects can be found at MedlinePlus Visit Here →

Does billing OPDUALAG require JZ/JW wastage modifiers?

CMS has identified OPDUALAG(J9298) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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