J1626 HCPCS code: Injection, granisetron hydrochloride, 100 mcg
J1626 is the HCPCS Level II code for injection, granisetron hydrochloride, 100 mcg. In 2024 Medicare paid an average of $0.25 per service for J1626 across 1,134,386 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 30 per day on outpatient hospital claims. Medicare volume fell 8% from 2022 to 2024 (1,232,072 to 1,134,386 services). In 2024, about 2,502 clinicians billed Medicare for J1626 for 16,672 beneficiaries; Texas, California, Virginia accounted for 37% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 1998-01-01 |
| Last action effective | 2009-01-01 |
Who bills J1626 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,502 |
| Medicare beneficiaries | 16,672 |
| States with claims | 43 |
| Share of services in top 3 states (Texas, California, Virginia) | 37% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1626, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,232,072 | 17,867 | $0.34 | $0.27 |
| 2023 | 1,197,674 | 17,454 | $0.37 | $0.30 |
| 2024 | 1,134,386 | 16,672 | $0.31 | $0.25 |
States with the most J1626 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 219,101 | $0.25 |
| California | 115,395 | $0.25 |
| Virginia | 85,183 | $0.25 |
| Florida | 57,543 | $0.25 |
| Maryland | 54,924 | $0.22 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 30 | Clinical: Data |
| practitioner claims | 30 | Clinical: Data |
What changed for J1626
- 1998-01-01: J1626 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J1626?
J1626 is the HCPCS Level II code for injection, granisetron hydrochloride, 100 mcg. Short descriptor: "Granisetron hcl injection".
How much does Medicare pay for J1626?
In 2024, the average Medicare payment was $0.25 per service (average allowed $0.31).
Does Medicare cover J1626?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1626 can be billed per day?
30 on outpatient hospital claims; 30 on practitioner claims (NCCI medically unlikely edits).
Related J16 codes
- J1600 — Injection, gold sodium thiomalate, up to 50 mg
- J1602 — Injection, golimumab, 1 mg, for intravenous use
- J1610 — Injection, glucagon hydrochloride, per 1 mg
- J1611 — Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg
- J1612 — Injection, glucagon (gvoke), 0.01 mg
- J1620 — Injection, gonadorelin hydrochloride, per 100 mcg
- J1627 — Injection, granisetron, extended-release, 0.1 mg
- J1628 — Injection, guselkumab, 1 mg
- J1630 — Injection, haloperidol, up to 5 mg
- J1631 — Injection, haloperidol decanoate, per 50 mg
- J1632 — Injection, brexanolone, 1 mg
- J1640 — Injection, hemin, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J1626
- Watch J1626 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1626
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.