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HCPCS code J9201: Gemcitabine injection, per 200 mg2026 Medicare rate & RVUs

Reports gemcitabine hydrochloride used in cancer treatment, with each HCPCS unit representing 200 mg of the drug administered.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J9201

Gemcitabine injection, per 200 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 J9201 →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 J9201 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 J9201 covers

J9201 identifies gemcitabine hydrochloride, an antineoplastic drug commonly given by intravenous infusion. Oncology practices and hospital departments report it when administering gemcitabine for cancers such as pancreatic, lung, breast, ovarian, or bladder cancer. The code identifies the drug, not the infusion service; administration is reported separately when appropriate.

CMS excludes J9201 from the physician fee schedule under status E. When Medicare covers the drug, payment follows another method; CMS classifies it as a Part B drug generally priced using its quarterly Average Sales Price drug files. Special Medicare coverage instructions apply. One HCPCS unit represents 200 mg, so divide the documented amount administered by 200 mg to determine units—for example, 1,000 mg is 5 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 J9201 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

J9201 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

J9201 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
J9201 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 J9201 rate is calculated

Each of J9201’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 · J9201

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 J9201

J9201 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 · J9201

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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J9201 isn’t priced in this setting.

J9201 compared with similar codes

Compare codes · National

J9201 vs J9205 vs J9206: Medicare rates

Office or facility?

  • J9201

    Gemcitabine injection, per 200 mg0 wRVU

    Not priced

  • J9205

    Liposomal irinotecan, per 1 mg0 wRVU

    Not priced

  • J9206

    Irinotecan injection, per 20 mg0 wRVU

    Not priced

How to choose

J9205Liposomal irinotecanPer 1 mg
J9205 identifies irinotecan liposome, not gemcitabine. Its HCPCS unit is 1 mg rather than 200 mg.
J9206Irinotecan injectionPer 20 mg
J9206 identifies irinotecan injection. Use J9201 for gemcitabine hydrochloride; these are different antineoplastic drugs.

Codes related to J9201

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

Codes related to J9201
CodeHow it relatesNational office range
Often billed with
96413Chemo IV infusion, initial drug, first hourMay report the initial chemotherapy infusion service when gemcitabine is infused.$114.99–$186.95
J9060Cisplatin injection, per 10 mgCisplatin is commonly administered with gemcitabine in combination cancer regimens.No office rate
J9045Carboplatin, per 50 mgCarboplatin is commonly administered with gemcitabine in combination cancer regimens.No office rate

J9201 billing questions

How many units should be reported?

Each unit represents 200 mg of gemcitabine hydrochloride. Divide the documented amount administered by 200 mg.

Does J9201 include the infusion service?

No. J9201 identifies the drug; report the applicable chemotherapy administration service separately when furnished and supported by the record.

What documentation supports the drug units?

Document the gemcitabine administered and its dose so the reported units can be calculated in 200 mg increments.

How does Medicare treat J9201?

CMS assigns physician fee schedule status E, excluding the code from that schedule. When covered, it is treated as a Part B drug generally priced through quarterly ASP drug files, with special Medicare coverage instructions.

How is J9201 different from J9205?

J9201 is for gemcitabine hydrochloride, with units of 200 mg. J9205 identifies irinotecan liposome, a different drug with a 1 mg unit.

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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