J1640 HCPCS code: Injection, hemin, 1 mg
J1640 is the HCPCS Level II code for injection, hemin, 1 mg. In 2024 Medicare paid an average of $24.77 per service for J1640 across 102,923 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 672 per day on outpatient hospital claims. Medicare volume rose 63% from 2022 to 2024 (63,015 to 102,923 services). In 2024, about 80 clinicians billed Medicare for J1640 for 20 beneficiaries.
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 | 2006-01-01 |
| Last action effective | 2006-01-01 |
Who bills J1640 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 80 |
| Medicare beneficiaries | 20 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1640, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 63,015 | 19 | $24.89 | $19.90 |
| 2023 | 80,357 | 15 | $28.98 | $23.18 |
| 2024 | 102,923 | 20 | $30.93 | $24.77 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 672 | Prescribing Information |
| practitioner claims | 672 | Prescribing Information |
What changed for J1640
- 2006-01-01: J1640 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 J1640?
J1640 is the HCPCS Level II code for injection, hemin, 1 mg. Short descriptor: "Hemin, 1 mg".
How much does Medicare pay for J1640?
In 2024, the average Medicare payment was $24.77 per service (average allowed $30.93).
Does Medicare cover J1640?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1640 can be billed per day?
672 on outpatient hospital claims; 672 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
- J1626 — Injection, granisetron hydrochloride, 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
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J1640
- Watch J1640 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1640
Sources: CMS HCPCS Level II release October 2026; 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.