HCPCS code J7509: Oral methylprednisolone, per 4 mg2026 Medicare rate & RVUs in Michigan
Reports oral methylprednisolone furnished as a Medicare-covered drug, with each HCPCS unit representing 4 mg.
CMS doesn’t publish an office rate for J7509 in Michigan.
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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On this page 9 sections
What J7509 covers
J7509 identifies oral methylprednisolone, a corticosteroid used to reduce inflammation and suppress immune activity. It may be prescribed for inflammatory conditions or as part of immunosuppression after organ transplantation. Pharmacies and other suppliers that furnish the medication report the drug code; it represents the drug supplied, not an administration service.
The physician fee schedule assigns status X because the drug is not a physician service, so that schedule does not pay it. When covered, Medicare generally pays it as a Part B drug using CMS's quarterly Average Sales Price drug pricing files, and special Medicare coverage instructions apply. Each unit represents 4 mg; report units by dividing the total milligrams furnished by 4.
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 J7509 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | Unavailable | Unavailable |
| Rest of Michigan | Unavailable | Unavailable |
How the J7509 rate is calculated
Each of J7509’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 · J7509
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 J7509
J7509 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 · J7509
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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J7509 isn’t priced in this setting.
J7509 compared with similar codes
Compare codes · National
J7509 vs J7510 vs J7512: Medicare rates
How to choose
- J7510PrednisolonePer 5 mg
- Use J7509 for methylprednisolone and J7510 for prednisolone. The drugs have different unit doses, so apply the unit definition for the drug furnished.
- J7512PrednisonePer 1 mg
- J7512 identifies oral prednisone at 1 mg per unit; J7509 identifies oral methylprednisolone at 4 mg per unit.
J7509 billing questions
How many units should be reported?
Each unit represents 4 mg of oral methylprednisolone. Divide the total milligrams furnished by 4 to determine the units.
How is J7509 different from J7510?
J7509 is for oral methylprednisolone, while J7510 is for oral prednisolone. Select the code for the drug furnished.
How is J7509 different from J7512?
J7512 identifies oral prednisone, not methylprednisolone. J7512 represents 1 mg per unit; J7509 represents 4 mg per unit.
Does the physician fee schedule pay J7509?
No. Its status X means it is not a physician service and is not paid under the physician fee schedule.
How does Medicare price J7509 when covered?
It is classified as a Part B drug and generally uses CMS's quarterly Average Sales Price drug pricing files when covered. Special Medicare coverage instructions apply.
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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