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HCPCS code J3490: Unclassified drug, no drug-specific code2026 Medicare rate & RVUs

Identifies an unclassified drug when no drug-specific HCPCS Level II code describes it; covered Part B drugs generally use ASP pricing.

CMS RVU26DEffective Oct 1, 2026109 payment localities605.1K Medicare services in 2024

Medicare rate · J3490

Unclassified drug, no drug-specific code

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 J3490 →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 J3490 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 J3490 covers

J3490 identifies an unclassified drug when no more specific HCPCS Level II drug code describes the product. It does not name a particular medication, route, formulation, or dose. Compare the product with drug-specific codes before selecting J3490. For example, J3410 identifies hydroxyzine injection, J3411 identifies thiamine hydrochloride, and J3420 identifies vitamin B12 injection. Those codes apply when they describe the product; J3490 is not selected simply because a drug is administered by injection.

CMS assigns J3490 physician fee schedule status E, excluding it from the physician fee schedule. When Medicare covers the item or service, payment is made under another payment method. For Part B drugs, Medicare generally pays using CMS quarterly Average Sales Price drug pricing files. Special Medicare coverage instructions apply.

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 J3490 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

J3490 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

J3490 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
J3490 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 J3490 rate is calculated

Each of J3490’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 · J3490

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 J3490

J3490 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 · J3490

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

J3490 isn’t priced in this setting.

J3490 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • J3490

    Unclassified drug, no drug-specific code0 wRVU

    Not priced

  • J3590

    Unclassified biologic, no product-specific code0 wRVU

    Not priced

  • J9999

    Antineoplastic drug, not otherwise classified0 wRVU

    Not priced

  • J7999

    Compounded drug, no specific HCPCS drug code0 wRVU

    Not priced

How to choose

J3590Unclassified biologicNo product-specific code
J3590 is for an unclassified biologic drug. J3490 identifies an unclassified drug outside that biologic category.
J9999Antineoplastic drugNot otherwise classified
J9999 is for an unclassified antineoplastic drug. J3490 is used for an unclassified drug outside that category.
J7999Compounded drugNo specific HCPCS drug code
J7999 identifies a compounded drug. J3490 identifies an unclassified drug when the compounded-drug code does not describe the product.

Codes related to J3490

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

Codes related to J3490
CodeHow it relatesNational office range
Used instead
J3590Unclassified biologic, no product-specific codeFor an unclassified biologic drug, J3590 is the class-specific alternative to J3490.No office rate
J9999Antineoplastic drug, not otherwise classifiedFor an unclassified antineoplastic drug, J9999 is the class-specific alternative to J3490.No office rate
J7999Compounded drug, no specific HCPCS drug codeJ7999 identifies a compounded drug when that code describes the product instead of J3490.No office rate

J3490 billing questions

When should J3490 be used instead of a drug-specific code?

Use J3490 when no more specific HCPCS Level II drug code describes the product. When a drug-specific code matches the product, use that code instead.

How does J3490 differ from J3590?

J3590 is for an unclassified biologic drug. J3490 identifies other unclassified drugs.

How many units should be reported?

J3490 does not define a drug-specific dose per unit. It identifies an unclassified drug rather than a particular medication or dose.

How does Medicare treat J3490?

It has physician fee schedule status E. When Medicare covers the item or service, payment is made under another method; covered Part B drugs generally use CMS quarterly ASP drug pricing files.

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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