J9200 HCPCS code: Injection, floxuridine, 500 mg
J9200 is the HCPCS Level II code for injection, floxuridine, 500 mg. In 2024 Medicare paid an average of $2,045.46 per service for J9200 across 44 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 16 per day on DME suppliers. In 2024, about 24 clinicians billed Medicare for J9200 for 14 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 | O1D — Chemotherapy |
| Added | 1984-01-01 |
| Last action effective | 2024-01-01 |
Who bills J9200 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 24 |
| Medicare beneficiaries | 14 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9200, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 44 | 14 | $2,567.90 | $2,045.46 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 16 | Clinical: Data |
| outpatient hospital claims | 20 | Clinical: Data |
| practitioner claims | 5 | Clinical: Data |
Medicare policy articles for this code
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B))
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B))
Covered diagnoses (2,020 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| A18.01 | Tuberculosis of spine | 1 |
| B02.23 | Postherpetic polyneuropathy | 1 |
| C00.0 | Malignant neoplasm of external upper lip | 1 |
| C00.1 | Malignant neoplasm of external lower lip | 1 |
| C00.3 | Malignant neoplasm of upper lip, inner aspect | 1 |
| C00.4 | Malignant neoplasm of lower lip, inner aspect | 1 |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified | 1 |
| C00.8 | Malignant neoplasm of overlapping sites of lip | 1 |
| C01 | Malignant neoplasm of base of tongue | 1 |
| C02.0 | Malignant neoplasm of dorsal surface of tongue | 1 |
Showing 10 of 2,020. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J9200
- 1984-01-01: J9200 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 J9200?
J9200 is the HCPCS Level II code for injection, floxuridine, 500 mg. Short descriptor: "Floxuridine injection".
How much does Medicare pay for J9200?
In 2024, the average Medicare payment was $2,045.46 per service (average allowed $2,567.90).
Does Medicare cover J9200?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J9200?
Medicare policy articles that cite J9200 list 2,020 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include A18.01 (Tuberculosis of spine), B02.23 (Postherpetic polyneuropathy), C00.0 (Malignant neoplasm of external upper lip). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J9200 can be billed per day?
16 on DME suppliers; 20 on outpatient hospital claims; 5 on practitioner claims (NCCI medically unlikely edits).
Related J92 codes
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- J9202 — Goserelin acetate implant, per 3.6 mg
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- J9204 — Injection, mogamulizumab-kpkc, 1 mg
- J9205 — Injection, irinotecan liposome, 1 mg
- J9206 — Injection, irinotecan, 20 mg
- J9207 — Injection, ixabepilone, 1 mg
- J9208 — Injection, ifosfamide, 1 gram
- J9209 — Injection, mesna, 200 mg
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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 J9200
- Watch J9200 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9200
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.