HCPCS code J9190: Fluorouracil injection, 500 mg per unit2026 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 J9190 covers

Fluorouracil is an antimetabolite chemotherapy drug used in regimens for cancers such as colorectal and breast cancer. Oncology clinicians administer the injectable drug by intravenous injection or infusion, including in hospital outpatient departments and physician offices. J9190 identifies the drug, not the chemotherapy administration service.

J9190 has Medicare status I and is not valid for Medicare reporting; Medicare uses J9192 for generic fluorouracil injection. J9190 describes 500 mg per unit, while J9192 uses 10 mg units. The 500 mg unit does not make J9190 valid for a Medicare claim. For covered Part B drug claims reported with a valid code, Medicare generally uses CMS quarterly Average Sales Price drug pricing files. The HCPCS coverage code indicates that 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 J9190 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

J9190 rates by state

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

How the J9190 rate is calculated

Each of J9190’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 J9190

J9190 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.

J9190 compared with similar codes

How to choose

J9192Fluorouracil injectionPer 10 mg

J9192 identifies generic fluorouracil in 10 mg units and is the code Medicare uses instead. J9190 describes 500 mg per unit but is not valid for Medicare reporting.

J9191Avyxa fluorouracilPer 10 mg

J9191 identifies Avyxa fluorouracil in 10 mg units. J9190 describes fluorouracil in 500 mg units and is not valid for Medicare reporting.

96413Chemo IV infusionInitial drug, first hour

96413 identifies chemotherapy infusion administration, while J9190 identifies the fluorouracil drug and is not valid for Medicare reporting.

Codes related to J9190

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