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Drug / Biological

J9190 Medicare Reimbursement Rate (2026)

Current CMS pricing and breakdown for Injection, fluorouracil, 500 mg.

HCPCS Code J9190National Fixed Rate

National Average Payment

Non-Facility (Private Office) Rate

$2.06
Effective Q2 2026

ℹ️ Good to Know

This item has a standard price nationwide. Your local rate will likely match the amount shown above.

Code Description

Injection, fluorouracil, 500 mg

Reimbursement Summary

The 2026 National Medicare reimbursement for J9190 is $2.06. This item is paid at a standard national rate, so local variation is typically minimal.

Description: Injection, fluorouracil, 500 mg. Payment policies and coverage rules can still vary by setting and claim details, so confirm final guidance through CMS when needed.

Note: amounts shown are estimates based on CMS national averages for Q2 2026.

Historical Medicare Reimbursement

2025 Q12025 Q22025 Q32025 Q42026 Q12026 Q2
QuarterNon-Facility RateFacility RateYoY % Change (Non-Fac)YoY % Change (Fac)
2026 Q2$2.06$2.06-6.80%-6.80%
2026 Q1$1.94$1.94-12.96%-12.96%
2025 Q4$1.99$1.99
2025 Q3$1.72$1.72
2025 Q2$2.21$2.21
2025 Q1$2.23$2.23

Facility vs. Non-Facility (Office) Payment

Facility vs. non-facility pricing most commonly applies to physician services paid under the RVU-based Physician Fee Schedule. For J9190 (Drug / Biological), the payment methodology may not include both facility and non-facility rates.

Q2 2026 Breakdown

ComponentOffice (Non-Fac)Facility (Hosp)
Work RVU
Practice Expense (PE)
Malpractice (MP)
Total RVUs0.000.00

Learn How This Reimbursement Is Calculated

Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.

Frequently Asked Questions

What is the 2026 Medicare rate for J9190?

The 2026 National Average Medicare reimbursement rate for J9190 (Drug / Biological) is $2.06. This rate is effective as of January 1, 2026.

What is the description for code J9190?

Injection, fluorouracil, 500 mg

Why do facility and non-facility payments differ for J9190?

Facility vs. non-facility differences usually apply to RVU-based physician services. J9190 may not use both facility and non-facility pricing depending on its payment methodology.

How can I find my local Medicare rate for J9190?

Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.

Is J9190 covered by Medicare?

Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.