J9190 HCPCS code: Injection, fluorouracil, 500 mg
J9190 is the HCPCS Level II code for injection, fluorouracil, 500 mg. In 2024 Medicare paid an average of $2.27 per service for J9190 across 1,069,256 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 20 per day on DME suppliers. Medicare volume fell 5% from 2022 to 2024 (1,122,447 to 1,069,256 services). In 2024, 51 suppliers billed Medicare for J9190 (purchases), serving 1,793 beneficiaries; Pennsylvania, New Jersey, Virginia accounted for 62% 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 | O1D — Chemotherapy |
| Added | 1984-01-01 |
| Last action effective | 2009-01-01 |
Who bills J9190 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 51 |
| Referring clinicians | 593 |
| Medicare beneficiaries | 1,793 |
| States with claims | 31 |
| Share of services in top 3 states (Pennsylvania, New Jersey, Virginia) | 62% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 88 | 2,593 |
| 2023 | 64 | 2,129 |
| 2024 | 51 | 1,793 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9190, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,122,447 | 28,417 | $2.06 | $1.64 |
| 2023 | 1,073,769 | 28,684 | $2.33 | $1.85 |
| 2024 | 1,069,256 | 30,170 | $2.87 | $2.27 |
States with the most J9190 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 136,522 | $2.28 |
| Florida | 127,163 | $2.29 |
| California | 110,208 | $2.30 |
| Illinois | 62,669 | $2.29 |
| Virginia | 46,277 | $2.30 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 20 | Clinical: Data |
| outpatient hospital claims | 20 | Clinical: Data |
| practitioner claims | 20 | Clinical: Data |
Medicare policy articles for this code
- A55639: Billing and Coding: Chemotherapy Agents for Non-Oncologic Conditions (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
Covered diagnoses (564 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| A63.0 | Anogenital (venereal) warts | 1 |
| B07.0 | Plantar wart | 1 |
| B07.8 | Other viral warts | 1 |
| B07.9 | Viral wart, unspecified | 1 |
| B27.00 | Gammaherpesviral mononucleosis without complication | 1 |
| B27.01 | Gammaherpesviral mononucleosis with polyneuropathy | 1 |
| B27.02 | Gammaherpesviral mononucleosis with meningitis | 1 |
| B27.09 | Gammaherpesviral mononucleosis with other complications | 1 |
| D47.3 | Essential (hemorrhagic) thrombocythemia | 1 |
| D47.Z1 | Post-transplant lymphoproliferative disorder (PTLD) | 1 |
Showing 10 of 564. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J9190
- 1984-01-01: J9190 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 J9190?
J9190 is the HCPCS Level II code for injection, fluorouracil, 500 mg. Short descriptor: "Fluorouracil injection".
How much does Medicare pay for J9190?
In 2024, the average Medicare payment was $2.27 per service (average allowed $2.87).
Does Medicare cover J9190?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J9190?
Medicare policy articles that cite J9190 list 564 covered ICD-10-CM diagnosis codes across 1 article. The most cited include A63.0 (Anogenital (venereal) warts), B07.0 (Plantar wart), B07.8 (Other viral warts). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J9190 can be billed per day?
20 on DME suppliers; 20 on outpatient hospital claims; 20 on practitioner claims (NCCI medically unlikely edits).
Related J91 codes
- J9100 — Injection, cytarabine, 100 mg
- J9118 — Injection, calaspargase pegol-mknl, 10 units
- J9119 — Injection, cemiplimab-rwlc, 1 mg
- J9120 — Injection, dactinomycin, 0.5 mg
- J9130 — Dacarbazine, 100 mg
- J9144 — Injection, daratumumab, 10 mg and hyaluronidase-fihj
- J9145 — Injection, daratumumab, 10 mg
- J9150 — Injection, daunorubicin, 10 mg
- J9151 — Injection, daunorubicin citrate, liposomal formulation, 10 mg
- J9153 — Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
- J9155 — Injection, degarelix, 1 mg
- J9160 — Injection, denileukin diftitox, 300 micrograms
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Next steps
- Run a reimbursement report for a device billed under J9190
- Watch J9190 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9190
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.