HCPCS code J3490: Unclassified drug, no drug-specific code2026 Medicare rate & RVUs in Puerto Rico
Identifies an unclassified drug when no drug-specific HCPCS Level II code describes it; covered Part B drugs generally use ASP pricing.
CMS doesn’t publish a rate for J3490 in Puerto Rico.
Check a contract rate as a % of Medicare · J3490 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Puerto Rico compares for J3490
- Puerto Rico · this pageUnavailable
- Los Angeles, CA · CaliforniaUnavailable
- Washington, DC area · District of ColumbiaUnavailable
- Miami, FL · FloridaUnavailable
- Chicago, IL · IllinoisUnavailable
- Manhattan, NY · New YorkUnavailable
- Alaska · AlaskaUnavailable
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
J3490 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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.
How J3490 has changed in Puerto Rico
J3490 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Separate payment rules apply | Separate payment rules apply | RVU26D |
| 2026-07-01 | Separate payment rules apply | Separate payment rules apply | RVU26C |
| 2026-04-01 | Separate payment rules apply | Separate payment rules apply | RVU26B |
| 2026-01-01 | Separate payment rules apply | Separate payment rules apply | RVU26A |
| 2025-10-01 | Separate payment rules apply | Separate payment rules apply | RVU25D |
| 2025-07-01 | Separate payment rules apply | Separate payment rules apply | RVU25C |
| 2025-04-01 | Separate payment rules apply | Separate payment rules apply | RVU25B |
| 2025-01-01 | Separate payment rules apply | Separate payment rules apply | RVU25A |
| 2024-10-01 | Separate payment rules apply | Separate payment rules apply | RVU24D |
| 2024-07-01 | Separate payment rules apply | Separate payment rules apply | RVU24C |
| 2024-04-01 | Separate payment rules apply | Separate payment rules apply | RVU24B |
| 2024-03-09 | Separate payment rules apply | Separate payment rules apply | RVU24AR |
| 2024-01-01 | Separate payment rules apply | Separate payment rules apply | RVU24A |
| 2023-10-01 | Separate payment rules apply | Separate payment rules apply | RVU23D |
| 2023-07-01 | Separate payment rules apply | Separate payment rules apply | RVU23C |
| 2023-04-01 | Separate payment rules apply | Separate payment rules apply | RVU23B |
| 2023-01-01 | Separate payment rules apply | Separate payment rules apply | RVU23A |
| 2022-10-01 | Separate payment rules apply | Separate payment rules apply | RVU22D |
| 2022-07-01 | Separate payment rules apply | Separate payment rules apply | RVU22C |
| 2022-04-01 | Separate payment rules apply | Separate payment rules apply | RVU22B |
| 2022-01-01 | Separate payment rules apply | Separate payment rules apply | RVU22A |
| 2021-10-01 | Separate payment rules apply | Separate payment rules apply | RVU21D |
| 2021-07-01 | Separate payment rules apply | Separate payment rules apply | RVU21C |
| 2021-04-01 | Separate payment rules apply | Separate payment rules apply | RVU21B |
| 2021-01-01 | Separate payment rules apply | Separate payment rules apply | RVU21A |
| 2020-10-01 | Separate payment rules apply | Separate payment rules apply | RVU20D |
| 2020-07-01 | Separate payment rules apply | Separate payment rules apply | RVU20C |
| 2020-04-01 | Separate payment rules apply | Separate payment rules apply | RVU20B |
| 2020-01-01 | Separate payment rules apply | Separate payment rules apply | RVU20A |
| 2019-10-01 | Separate payment rules apply | Separate payment rules apply | RVU19D |
| 2019-07-01 | Separate payment rules apply | Separate payment rules apply | RVU19C |
| 2019-04-01 | Separate payment rules apply | Separate payment rules apply | RVU19B |
| 2019-01-01 | Separate payment rules apply | Separate payment rules apply | RVU19A |
| 2018-10-01 | Separate payment rules apply | Separate payment rules apply | RVU18D |
| 2018-07-01 | Separate payment rules apply | Separate payment rules apply | RVU18C |
| 2018-04-01 | Separate payment rules apply | Separate payment rules apply | RVU18B |
| 2018-01-01 | Separate payment rules apply | Separate payment rules apply | RVU18AR1 |
| 2017-10-01 | Separate payment rules apply | Separate payment rules apply | RVU17D |
| 2017-07-01 | Separate payment rules apply | Separate payment rules apply | RVU17C |
| 2017-04-01 | Separate payment rules apply | Separate payment rules apply | RVU17B |
| 2017-01-01 | Separate payment rules apply | Separate payment rules apply | RVU17A |
| 2016-10-01 | Separate payment rules apply | Separate payment rules apply | RVU16D |
| 2016-07-01 | Separate payment rules apply | Separate payment rules apply | RVU16C |
| 2016-04-01 | Separate payment rules apply | Separate payment rules apply | RVU16B |
| 2016-01-01 | Separate payment rules apply | Separate payment rules apply | RVU16A |
| 2015-10-01 | Separate payment rules apply | Separate payment rules apply | RVU15D |
| 2015-07-01 | Separate payment rules apply | Separate payment rules apply | RVU15C |
| 2015-04-01 | Separate payment rules apply | Separate payment rules apply | RVU15B |
| 2015-01-01 | Separate payment rules apply | Separate payment rules apply | RVU15A |
| 2014-10-01 | Separate payment rules apply | Separate payment rules apply | RVU14D |
| 2014-07-01 | Separate payment rules apply | Separate payment rules apply | RVU14C |
| 2014-04-01 | Separate payment rules apply | Separate payment rules apply | RVU14B |
| 2014-01-01 | Separate payment rules apply | Separate payment rules apply | RVU14A |
| 2013-10-01 | Separate payment rules apply | Separate payment rules apply | RVU13D |
| 2013-07-01 | Separate payment rules apply | Separate payment rules apply | RVU13C |
| 2013-04-01 | Separate payment rules apply | Separate payment rules apply | RVU13B |
| 2013-01-01 | Separate payment rules apply | Separate payment rules apply | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
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
Fee sheets · Coming soon
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