HCPCS code J0893: Decitabine injection, sun Pharma product, per 1 mg2026 Medicare rate & RVUs in Missouri
Reports 1 mg of the Sun Pharma decitabine product administered by infusion for treatment of myelodysplastic syndromes.
CMS doesn’t publish an office rate for J0893 in Missouri.
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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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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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.
How the rate is built · J0893
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 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.
Place of service · J0893
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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J0893 isn’t priced in this setting.
J0893 compared with similar codes
Compare codes · National
J0893 vs J0894 vs 96413: Medicare rates
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.
J0893 billing questions
When should I report J0893 instead of J0894?
Use J0893 for the Sun Pharma decitabine product. J0894 identifies a different decitabine product that CMS treats as not therapeutically equivalent.
How many milligrams does one unit represent?
One J0893 unit represents 1 mg. Report the total administered dose in milligrams as the corresponding number of units.
Does status E mean Medicare never pays for J0893?
No. Status E excludes the code from the physician fee schedule; when Medicare covers the drug, payment is through another method.
How is J0893 priced when Medicare covers it?
CMS classifies J0893 as a Part B drug, generally priced from the quarterly Average Sales Price files. The Medicare contractor determines coverage.
Does J0893 include the infusion administration?
J0893 reports the drug and its quantity, not the infusion service. Report an applicable administration service separately when it is separately reportable.
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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