J1642 HCPCS code: Injection, heparin sodium, (heparin lock flush), per 10 units
J1642 is the HCPCS Level II code for injection, heparin sodium, (heparin lock flush), per 10 units. In 2024 Medicare paid an average of $0.01 per service for J1642 across 386,515 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 150 per day on outpatient hospital claims. Medicare volume fell 44% from 2022 to 2024 (694,264 to 386,515 services). In 2024, about 444 clinicians billed Medicare for J1642 for 1,970 beneficiaries; California, Arizona, South Carolina accounted for 79% 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 | 1995-01-01 |
| Last action effective | 1997-01-01 |
Who bills J1642 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 444 |
| Medicare beneficiaries | 1,970 |
| States with claims | 9 |
| Share of services in top 3 states (California, Arizona, South Carolina) | 79% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1642, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 694,264 | 3,084 | $0.02 | $0.01 |
| 2023 | 614,447 | 2,547 | $0.03 | $0.02 |
| 2024 | 386,515 | 1,970 | $0.02 | $0.01 |
States with the most J1642 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 205,066 | $0.01 |
| Arizona | 56,452 | $0.01 |
| South Carolina | 38,903 | $0.01 |
| Washington | 18,850 | $0.01 |
| South Dakota | 17,150 | $0.01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 150 | Clinical: Data |
| practitioner claims | 100 | Clinical: Data |
What changed for J1642
- 1995-01-01: J1642 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 J1642?
J1642 is the HCPCS Level II code for injection, heparin sodium, (heparin lock flush), per 10 units. Short descriptor: "Inj heparin sodium per 10 u".
How much does Medicare pay for J1642?
In 2024, the average Medicare payment was $0.01 per service (average allowed $0.02).
Does Medicare cover J1642?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1642 can be billed per day?
150 on outpatient hospital claims; 100 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
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Next steps
- Run a reimbursement report for a device billed under J1642
- Watch J1642 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1642
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.