HCPCS code J0893: Decitabine injection, sun Pharma product, per 1 mg2026 Medicare rate & RVUs

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

What J0893 covers

J0893 identifies the Sun Pharma decitabine product, an intravenous antineoplastic medicine used to treat myelodysplastic syndromes. Hematology and oncology clinicians typically order and oversee treatment, while infusion staff prepare and administer the drug in an outpatient infusion center or hospital. The drug code identifies the product and quantity, not the infusion service itself.

Medicare assigns this code physician fee schedule status E, meaning it is excluded from the physician fee schedule; when covered, Medicare pays through another payment method. CMS classifies it as a Part B drug, generally priced from the quarterly Average Sales Price files when covered. The Medicare contractor determines coverage. Each unit represents 1 mg, so report the administered dose in milligrams. Use J0893 for the Sun Pharma product rather than J0894, which identifies decitabine that CMS treats as not therapeutically equivalent.

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 J0893 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

J0893 rates by state

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

How the J0893 rate is calculated

Each of J0893’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.

Payment rules and modifiers for J0893

J0893 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.

J0893 compared with similar codes

How to choose

J0894Decitabine injectionPer 1 mg

Both codes identify decitabine, but J0893 is specific to the Sun Pharma product. CMS identifies J0894 as a product not therapeutically equivalent to J0893.

96413Chemo IV infusionInitial drug, first hour

J0893 reports the decitabine drug and its quantity; 96413 reports chemotherapy infusion administration when applicable.

Codes related to J0893

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

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