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HCPCS code J9191: Avyxa fluorouracil, per 10 mg2026 Medicare rate & RVUs

Identifies Avyxa fluorouracil administered as injectable chemotherapy, with each HCPCS unit representing 10 mg of drug.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J9191

Avyxa fluorouracil, per 10 mg

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for J9191 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What J9191 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What J9191 covers

J9191 identifies injectable fluorouracil supplied as Avyxa, an antimetabolite used in cancer treatment. Oncology clinicians in practices and hospital outpatient infusion departments administer it intravenously by injection or infusion as part of a prescribed chemotherapy regimen. The code is product-specific: choose it when the administered product is Avyxa rather than another fluorouracil product represented by a neighboring entry.

CMS assigns status E, excluding J9191 from the physician fee schedule. When Medicare covers the drug, payment is under another method; HCPCS identifies it as a Part B drug generally priced using CMS quarterly ASP drug pricing files. Coverage is left to the Medicare contractor's judgment. One unit represents 10 mg, so divide the documented administered dose in milligrams by 10 to calculate units.

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 J9191 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

J9191 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

J9191 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
J9191 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the J9191 rate is calculated

Each of J9191’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 · J9191

RVUs × geographic indexes × conversion factor

Office or facility?

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 J9191

J9191 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 · J9191

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

J9191 isn’t priced in this setting.

J9191 compared with similar codes

Compare codes · National

J9191 vs J9190 vs J9192: Medicare rates

Office or facility?

  • J9191

    Avyxa fluorouracil, per 10 mg0 wRVU

    Not priced

  • J9190

    Fluorouracil injection, 500 mg per unit0 wRVU

    Not priced

  • J9192

    Fluorouracil injection, per 10 mg0 wRVU

    Not priced

How to choose

J9190Fluorouracil injection500 mg per unit
J9190 is another fluorouracil injection entry. Select the code that corresponds to the product administered.
J9192Fluorouracil injectionPer 10 mg
J9192 is a separate 10-mg fluorouracil entry without Avyxa in its descriptor. J9191 identifies the Avyxa product; select the entry matching the product administered.

Codes related to J9191

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

Codes related to J9191
CodeHow it relatesNational office range
Same family
J9190Fluorouracil injection, 500 mg per unitAnother fluorouracil injection entry; select according to the product administered.No office rate
J9192Fluorouracil injection, per 10 mgA separate fluorouracil 10-mg entry; distinguish it from J9191 by the product administered.No office rate
Often billed with
96413Chemo IV infusion, initial drug, first hourChemotherapy infusion administration may be reported when the drug is administered by infusion.$114.99–$186.95

J9191 billing questions

When should J9191 be used instead of J9190 or J9192?

Use J9191 for the Avyxa fluorouracil product. Choose another fluorouracil entry when the administered product corresponds to that code instead.

How many units should be reported?

One unit represents 10 mg. Divide the documented administered dose in milligrams by 10 to calculate units.

Does J9191 include chemotherapy administration?

J9191 identifies the drug, not the administration service. Report the applicable chemotherapy administration service separately when it is performed.

How does Medicare treat payment for J9191?

CMS assigns status E, excluding J9191 from the physician fee schedule. When covered, it is a Part B drug generally priced through CMS quarterly ASP drug pricing files, and coverage is left to the Medicare contractor's judgment.

What should the record support for this code?

Document the Avyxa product administered and the total fluorouracil dose in milligrams so the reported 10-mg units can be verified.

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

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