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HCPCS code J0641: Levoleucovorin injection, per 0.5 mg2026 Medicare rate & RVUs

Reports injectable levoleucovorin used for methotrexate rescue or with fluorouracil in certain cancer regimens, in 0.5 mg billing units.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J0641

Levoleucovorin injection, per 0.5 mg

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for J0641 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What J0641 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What J0641 covers

Levoleucovorin is the active isomer of folinic acid. Oncology teams administer it by injection, typically intravenously, for rescue after high-dose methotrexate and as part of certain fluorouracil regimens, including treatment of colorectal cancer. The drug is commonly administered in physician offices and hospital outpatient oncology settings. Report this code for levoleucovorin that is not identified by a more specific product code.

CMS assigns this HCPCS Level II drug code physician fee schedule status E, meaning it is excluded from the physician fee schedule. When Medicare covers the drug, payment follows another method; CMS classifies it as a Part B drug generally priced using its quarterly Average Sales Price files. Special Medicare coverage instructions apply. Each unit represents 0.5 mg of levoleucovorin, so units reflect the administered dose in 0.5 mg increments.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where J0641 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

J0641 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

J0641 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
J0641 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the J0641 rate is calculated

Each of J0641’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · J0641

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for J0641

J0641 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · J0641

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

J0641 isn’t priced in this setting.

J0641 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • J0641

    Levoleucovorin injection, per 0.5 mg0 wRVU

    Not priced

  • J0642

    Levoleucovorin injection, khapzory, per 0.5 mg0 wRVU

    Not priced

  • J0640

    Leucovorin injection, per 50 mg0 wRVU

    Not priced

  • J0643

    Leucovorin injection, per 1 mg0 wRVU

    Not priced

How to choose

J0642Levoleucovorin injectionKhapzory, per 0.5 mg
J0642 identifies Khapzory, a specific levoleucovorin product. J0641 is for levoleucovorin not otherwise specified.
J0640Leucovorin injectionPer 50 mg
J0640 identifies leucovorin calcium injection. J0641 identifies levoleucovorin, so choose according to the drug administered.
J0643Leucovorin injectionPer 1 mg
J0643 identifies leucovorin calcium injection in 1 mg units; J0641 is levoleucovorin in 0.5 mg units.

Codes related to J0641

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to J0641
CodeHow it relatesNational office range
Used instead
J0642Levoleucovorin injection, khapzory, per 0.5 mgUse for the Khapzory product rather than levoleucovorin not otherwise specified.No office rate
J0640Leucovorin injection, per 50 mgIdentifies leucovorin calcium injection, a different folinic acid drug.No office rate
J0643Leucovorin injection, per 1 mgIdentifies leucovorin calcium injection per 1 mg rather than levoleucovorin.No office rate
Often billed with
J9190Fluorouracil injection, 500 mg per unitFluorouracil may be administered with levoleucovorin in certain oncology regimens.No office rate

J0641 billing questions

How many units should be reported?

One unit represents 0.5 mg of levoleucovorin. Report units based on the administered dose in 0.5 mg increments.

When should J0641 be used instead of J0642?

J0641 is for levoleucovorin not otherwise specified. Use J0642 when the administered product is Khapzory.

How does J0641 differ from leucovorin calcium codes?

J0641 identifies levoleucovorin, the active isomer. J0640 and J0643 identify leucovorin calcium; select the code that matches the drug administered.

Is J0641 paid under the physician fee schedule?

No. CMS assigns status E, excluding it from the physician fee schedule. When Medicare covers the drug, it generally uses the Part B drug pricing method based on quarterly ASP files.

Is levoleucovorin commonly reported with fluorouracil?

Yes. The drugs may be administered together in certain cancer regimens, including colorectal cancer treatment; J9190 identifies injectable fluorouracil.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates

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