J1938 HCPCS code: Injection, furosemide, 1 mg
J1938 is the HCPCS Level II code for injection, furosemide, 1 mg. 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 5360 per day on DME suppliers.
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 | 2025-04-01 |
| Last action effective | 2025-04-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 5360 | Prescribing Information |
| outpatient hospital claims | 5360 | Prescribing Information |
| practitioner claims | 5360 | Prescribing Information |
What changed for J1938
- April 2025: Code appears in this HCPCS release
- 2025-04-01: J1938 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 J1938?
J1938 is the HCPCS Level II code for injection, furosemide, 1 mg. Short descriptor: "Inj, furosemide, 1 mg".
Does Medicare cover J1938?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1938 can be billed per day?
5360 on DME suppliers; 5360 on outpatient hospital claims; 5360 on practitioner claims (NCCI medically unlikely edits).
Related J19 codes
- J1920 — Injection, labetalol hydrochloride, 5 mg
- J1921 — Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg
- J1930 — Injection, lanreotide, 1 mg
- J1931 — Injection, laronidase, 0.1 mg
- J1932 — Injection, lanreotide, (cipla), 1 mg
- J1939 — Injection, bumetanide, 0.5 mg
- J1940 — Injection, furosemide, up to 20 mg
- J1941 — Injection, furosemide (furoscix), 20 mg
- J1942 — Injection, aripiprazole lauroxil, 1 mg
- J1943 — Injection, aripiprazole lauroxil, (aristada initio), 1 mg
- J1944 — Injection, aripiprazole lauroxil, (aristada), 1 mg
- J1945 — Injection, lepirudin, 50 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 J1938
- Watch J1938 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1938
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.