HCPCS code J9190: Fluorouracil injection, 500 mg per unit2026 Medicare rate & RVUs in Maine
This code identifies a 500 mg amount of injectable fluorouracil, an antimetabolite chemotherapy drug, but Medicare does not accept it for reporting.
CMS doesn’t publish an office rate for J9190 in Maine.
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 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 in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | Unavailable | Unavailable |
| Southern Maine, ME | Unavailable | Unavailable |
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.
How the rate is built · J9190
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 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.
Place of service · J9190
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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J9190 isn’t priced in this setting.
J9190 compared with similar codes
Compare codes · National
4 codes, side by side
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.
J9190 billing questions
Can J9190 be billed to Medicare?
No. J9190 has Medicare status I and is not valid for Medicare reporting; Medicare uses J9192 for generic fluorouracil injection.
What does one J9190 unit represent?
One unit represents 500 mg of fluorouracil. Medicare uses J9192 for generic fluorouracil, with 10 mg units.
How does J9190 differ from J9191 and J9192?
J9191 identifies Avyxa fluorouracil in 10 mg units, and J9192 identifies generic fluorouracil in 10 mg units. J9190 describes 500 mg per unit and is not valid for Medicare reporting.
Is J9190 the chemotherapy administration service?
No. J9190 identifies the fluorouracil drug, not the chemotherapy administration service.
How does Medicare classify J9190?
J9190 has status I, meaning it is not valid for Medicare; Medicare uses a different code to report and pay for the service.
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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