HCPCS code J7999: Compounded drug, no specific HCPCS drug code2026 Medicare rate & RVUs

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What J7999 covers

J7999 identifies a compounded drug for which no more specific HCPCS drug code is used. Compounding combines drug ingredients or changes a preparation to produce the medication furnished to the patient. The billing clinician or facility reports it for a compounded medication furnished in an office or facility setting. It identifies the medication rather than the injection or infusion procedure used to administer it. Claim documentation should identify the actual compounded medication and amount furnished.

CMS assigns J7999 physician fee schedule status E, which excludes it from the physician fee schedule. When Medicare covers the medication, payment is made under another method. For a covered Part B drug, CMS generally prices it using quarterly Average Sales Price drug pricing files. Special Medicare coverage instructions apply to this code.

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 J7999 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

J7999 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the J7999 rate is calculated

Each of J7999’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.

Payment rules and modifiers for J7999

J7999 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.

J7999 compared with similar codes

How to choose

J3490Unclassified drugNo drug-specific code

J7999 identifies a compounded drug without a more specific HCPCS code. J3490 is the unclassified-drug code for a drug not reported as compounded.

J3590Unclassified biologicNo product-specific code

J3590 is the unclassified code for a biologic drug. J7999 identifies a compounded drug without a more specific HCPCS drug code.

J9999Antineoplastic drugNot otherwise classified

J9999 is the unclassified code for an antineoplastic drug. J7999 identifies a compounded drug without a more specific HCPCS drug code.

Codes related to J7999

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

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