HCPCS code J9201: Gemcitabine injection, per 200 mg2026 Medicare rate & RVUs in Texas
Reports gemcitabine hydrochloride used in cancer treatment, with each HCPCS unit representing 200 mg of the drug administered.
CMS doesn’t publish an office rate for J9201 in Texas.
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 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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | Unavailable |
| Beaumont, TX | Unavailable | Unavailable |
| Brazoria, TX | Unavailable | Unavailable |
| Dallas, TX | Unavailable | Unavailable |
| Fort Worth, TX | Unavailable | Unavailable |
| Galveston, TX | Unavailable | Unavailable |
| Houston, TX | Unavailable | Unavailable |
| Rest of Texas | Unavailable | Unavailable |
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
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
How to choose
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
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