C90.21: Extramedullary plasmacytoma in remission
C90.21, extramedullary plasmacytoma in remission, is listed as a covered diagnosis in 10 Medicare billing and coding articles that apply to 86 HCPCS Level II codes, including J1569 (Injection, immune globulin, (gammagard liquid/gammagard…), J1561 (Injection, immune globulin, (gamunex-c/gammaked)…), J1459 (Injection, immune globulin (privigen), intravenous…). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. The articles come from 4 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with C90.21 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| J1569 | Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg | Special coverage instructions apply | — | 1 |
| J1561 | Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 1 |
| J1459 | Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1576 | Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg | Special coverage instructions apply | — | 1 |
| J1557 | Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1556 | Injection, immune globulin (bivigam), 500 mg | Carrier judgment | — | 1 |
| J1568 | Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg | Carrier judgment | — | 1 |
| J1566 | Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg | Special coverage instructions apply | — | 1 |
| J1554 | Injection, immune globulin (asceniv), 500 mg | Carrier judgment | — | 1 |
| J1599 | Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg | Carrier judgment | — | 1 |
| J1577 | Injection, immune globulin (qivigy), 100 mg | Carrier judgment | — | 1 |
| Q0512 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period | Special coverage instructions apply | — | 2 |
| Q0511 | Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period | Special coverage instructions apply | — | 2 |
| J0897 | Injection, denosumab, 1 mg | Carrier judgment | — | 1 |
| Q5136 | Injection, denosumab-bbdz (jubbonti/wyost), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5157 | Injection, denosumab-bmwo (stoboclo/osenvelt), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5158 | Injection, denosumab-bnht (bomyntra/conexxence), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5159 | Injection, denosumab-dssb (ospomyv/xbryk), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5162 | Injection, denosumab-nxxp (bildyos/bilprevda), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5165 | Injection, denosumab-mobz (oziltus), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5166 | Injection, denosumab-desu (osvyrti/jubereq), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5167 | Injection, denosumab-qbde (enoby/xtrenbo), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5171 | Injection, denosumab-mobz (boncresa), biosimilar, 1 mg | Carrier judgment | — | 1 |
| Q5129 | Injection, bevacizumab-adcd (vegzelma), biosimilar, 10 mg | Carrier judgment | — | 1 |
| Q5126 | Injection, bevacizumab-maly, biosimilar, (alymsys), 10 mg | Carrier judgment | — | 1 |
61 more codes are listed. See every code with payment by region in Caduvo.
Medicare policy articles listing C90.21
- A59105: Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG) (Wellpoint Federal (MAC - Part A, MAC - Part B); 11 Level II codes). LCD with the same title: L39314
- A52399: Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 10 Level II codes)
- A52370: Billing and Coding: Bevacizumab and biosimilars (Wellpoint Federal (MAC - Part A, MAC - Part B); 8 Level II codes)
- A54768: Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy (Palmetto GBA (MAC - Part A, MAC - Part B); 5 Level II codes)
- A52479: Oral Anticancer Drugs - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 8 Level II codes). LCD with the same title: L33826
- A56462: Billing and Coding: Erythropoiesis Stimulating Agents (ESA) (CGS Administrators, LLC (MAC - Part A, MAC - Part B); 7 Level II codes). LCD with the same title: L34356
- A52480: Oral Antiemetic Drugs (Replacement for Intravenous Antiemetics) - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 19 Level II codes). LCD with the same title: L33827
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
- A57206: Billing and Coding: Lumbar MRI (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L34220
- A56612: Billing and Coding: CT of the Head (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34417
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other C90 diagnoses (Multiple myeloma and malignant plasma cell neoplasms)
- C90.20 — Extramedullary plasmacytoma not having achieved remission
- C90.22 — Extramedullary plasmacytoma in relapse
- C90.00 — Multiple myeloma not having achieved remission
- C90.01 — Multiple myeloma in remission
- C90.02 — Multiple myeloma in relapse
- C90.10 — Plasma cell leukemia not having achieved remission
- C90.11 — Plasma cell leukemia in remission
- C90.12 — Plasma cell leukemia in relapse
- C90.30 — Solitary plasmacytoma not having achieved remission
- C90.31 — Solitary plasmacytoma in remission
- C90.32 — Solitary plasmacytoma in relapse
Frequently asked questions
Does Medicare cover C90.21 (Extramedullary plasmacytoma in remission)?
Medicare covers items and services, not diagnoses. 10 Medicare billing and coding articles list C90.21 as a covered diagnosis for 86 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 C90.21?
The Level II codes from the policies most specific to this diagnosis are J1569 (Injection, immune globulin, (gammagard liquid/gammagard…, 1 article); J1561 (Injection, immune globulin, (gamunex-c/gammaked)…, 1 article); J1459 (Injection, immune globulin (privigen), intravenous…, 1 article); J1576 (Injection, immune globulin (panzyga), intravenous…, 1 article); J1557 (Injection, immune globulin, (gammaplex), intravenous…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with C90.21?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list C90.21?
A59105 (Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG)); A52399 (Billing and Coding: Denosumab (Prolia®, Xgeva®, Jubbonti®) and biosimilars); A52370 (Billing and Coding: Bevacizumab and biosimilars), and 7 more articles.
What is ICD-10-CM code C90.21?
C90.21 is the ICD-10-CM code for extramedullary plasmacytoma in remission, in category C90 (Multiple myeloma and malignant plasma cell neoplasms), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under J1569
- Watch J1569 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1569
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.