HCPCS code J3425: Hydroxocobalamin injection, per 10 mcg2026 Medicare rate & RVUs in Illinois
Reports intramuscular hydroxocobalamin given for vitamin B12 replacement, with each billing unit representing 10 mcg of the drug.
CMS doesn’t publish an office rate for J3425 in Illinois.
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 J3425 covers
This code identifies hydroxocobalamin administered by intramuscular injection, generally for vitamin B12 replacement, including treatment of B12 deficiency. Clinicians report the drug when they administer an intramuscular dose, including in office or outpatient care. It is distinct from hydroxocobalamin given intravenously and from other vitamin B12 products, even when the clinical purpose is similar.
CMS assigns status E, excluding the code from the physician fee schedule. When Medicare covers the item or service, payment is made under another method; HCPCS pricing identifies it as a Part B drug, generally priced through CMS quarterly Average Sales Price drug pricing files. Special Medicare coverage instructions apply. Each unit represents 10 mcg, so a documented 1,000 mcg dose corresponds to 100 units. Report units from the amount administered and retain documentation supporting the drug and dose.
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 J3425 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | Unavailable |
| East St. Louis, IL | Unavailable | Unavailable |
| Rest of Illinois | Unavailable | Unavailable |
| Suburban Chicago, IL | Unavailable | Unavailable |
How the J3425 rate is calculated
Each of J3425’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 · J3425
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 J3425
J3425 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 · J3425
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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J3425 isn’t priced in this setting.
J3425 compared with similar codes
Compare codes · National
J3425 vs J3424 vs J3420: Medicare rates
How to choose
- J3424Hydroxocobalamin injectionIntravenous, per 25 mg
- Use J3425 for intramuscular hydroxocobalamin per 10 mcg. J3424 identifies the intravenous route and a different dose basis.
- J3420Vitamin B12 injectionUp to 1,000 mcg
- J3420 is a separate vitamin B12 injection code associated with cyanocobalamin. J3425 identifies hydroxocobalamin administered intramuscularly.
J3425 billing questions
How many units represent a 1,000 mcg dose?
Each unit represents 10 mcg, so 1,000 mcg corresponds to 100 units.
Should this code be used for intravenous hydroxocobalamin?
No. This code is for intramuscular hydroxocobalamin; J3424 identifies hydroxocobalamin administered intravenously.
How does this differ from J3420?
J3425 identifies hydroxocobalamin per 10 mcg. J3420 is a separate vitamin B12 injection code associated with cyanocobalamin, not hydroxocobalamin.
Does Medicare pay this code under the physician fee schedule?
No. CMS assigns status E, excluding it from the physician fee schedule. When covered, payment follows another method; CMS identifies it as a Part B drug generally priced through quarterly ASP files.
What should the administration record support?
Document the hydroxocobalamin product, intramuscular route, and amount administered so the reported units can be verified.
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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