HCPCS code J0642: Levoleucovorin injection, khapzory, per 0.5 mg2026 Medicare rate & RVUs in Michigan
Reports injectable Khapzory levoleucovorin used for folinic acid rescue after high-dose methotrexate or methotrexate overdose, in 0.5 mg units.
CMS doesn’t publish an office rate for J0642 in Michigan.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What J0642 covers
J0642 identifies Khapzory, an injectable form of levoleucovorin, a folinic acid used to reduce the toxic effects of folic acid antagonists. Oncology clinicians use it for rescue after high-dose methotrexate and in methotrexate overdose or delayed drug elimination. The medication is given intravenously in settings such as oncology clinics and hospital outpatient departments. The code identifies the drug, not the service of administering it.
CMS assigns J0642 physician fee schedule status E, meaning it is excluded from the physician fee schedule. When Medicare covers the drug, it pays under another payment method; as a Part B drug, it is generally priced using CMS’s quarterly Average Sales Price drug files. Coverage is left to the Medicare contractor’s judgment. Each unit represents 0.5 mg of levoleucovorin, so the reported units reflect the amount administered 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 J0642 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | Unavailable |
| Rest of Michigan | Unavailable | Unavailable |
How the J0642 rate is calculated
Each of J0642’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 · J0642
RVUs × geographic indexes × conversion factor
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 J0642
J0642 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 · J0642
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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J0642 isn’t priced in this setting.
J0642 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- J0641Levoleucovorin injectionPer 0.5 mg
- Use J0642 for the specifically named Khapzory product. J0641 identifies levoleucovorin injection not otherwise specified.
- J0640Leucovorin injectionPer 50 mg
- J0640 identifies leucovorin calcium injection; J0642 identifies Khapzory levoleucovorin.
- J0643Leucovorin injectionPer 1 mg
- J0643 is for leucovorin calcium with a 1 mg unit. J0642 is for Khapzory levoleucovorin with a 0.5 mg unit.
- J0644Avyxa leucovorinPer 1 mg
- J0644 identifies Avyxa leucovorin calcium. J0642 identifies Khapzory levoleucovorin.
J0642 billing questions
What does one unit of J0642 represent?
One unit represents 0.5 mg of Khapzory levoleucovorin. Report units based on the amount administered in 0.5 mg increments.
How does J0642 differ from J0641?
J0642 identifies the Khapzory product. J0641 is for levoleucovorin injection not otherwise specified, rather than the specifically named Khapzory product.
How does J0642 differ from leucovorin calcium codes?
J0642 is for levoleucovorin (Khapzory). J0640 and J0643 identify leucovorin calcium products, which are different from the specifically named drug in J0642.
Does J0642 include the drug administration service?
No. J0642 identifies the drug quantity, not its administration. Any separately reportable administration service is coded under the applicable rules for the setting.
How does Medicare treat J0642?
CMS excludes it from the physician fee schedule. If Medicare covers the drug, it generally uses the Part B drug pricing method based on quarterly ASP files; coverage is left to the Medicare contractor’s judgment.
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
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