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HCPCS J9192 · Level II · Part B drug

HCPCS J9192: Injection, fluorouracil, 10 mg

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for J9192

Billing unit
10 MG
Inj, fluorouracil, 10 mg
ASP payment limit
$0.039
October 2026
Practitioner MUE
none published
CMS publishes no MUE for this code
OPPS status
not in Addendum B
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J9192 is the Level II code for Injection, fluorouracil, 10 mg, billed per 10 MG. The Medicare Part B ASP payment limit for October 2026 is $0.039 per billing unit. The 10 mg billing unit means doses are reported in multiples of ten milligrams, with any remainder rounded per contractor policy; mismatched units against the NDC quantity trigger MUE and NDC-unit edits. The ASP crosswalk maps 28 NDCs to it, sold as Fluorouracil by Sagent Pharmaceuticals, Eugia US LLC, Alembic Pharmaceuticals Inc.. No current Billing and Coding Article lists J9192, so coverage follows the FDA label, compendia and any applicable NCD.

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J9192 at $0.039 per 10 MG for October 2026, derived from manufacturer average sales price plus 6%. Beneficiary coinsurance is 20%.

ASP payment limits for J9192
QuarterPayment limitPerCoinsurance
October 2026$0.03910 MG20%
July 2026n/a10 MG—
CMS note: Added October 2026

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 28 NDCs from 7 labelers to J9192. Report the NDC in the claim's drug segment and bill the number of J9192 units that equals the quantity administered divided by 10 MG; the last column gives units per full package.

NDCs that crosswalk to J9192
NDCDrug nameLabelerPackage sizeBilling units / package
25021-0215-98FluorouracilSagent Pharmaceuticals50 × 1250
25021-0215-99FluorouracilSagent Pharmaceuticals100 × 1500
55150-0498-01FluorouracilEugia US LLC50 × 1250
55150-0499-01FluorouracilEugia US LLC100 × 1500
62332-0751-50FluorouracilAlembic Pharmaceuticals Inc.50 × 1250
62332-0779-31FluorouracilAlembic Pharmaceuticals Inc.100 × 1500
63323-0117-10FluorouracilFreseniUS Kabi USA, LLC10 × 10500
63323-0117-18FluorouracilFreseniUS Kabi USA, LLC10 × 10500
63323-0117-19FluorouracilFreseniUS Kabi USA, LLC10 × 10500
63323-0117-20FluorouracilFreseniUS Kabi USA, LLC20 × 101000
63323-0117-51FluorouracilFreseniUS Kabi USA, LLC50 × 1250
63323-0117-58FluorouracilFreseniUS Kabi USA, LLC50 × 1250
63323-0117-59FluorouracilFreseniUS Kabi USA, LLC50 × 1250
63323-0117-61FluorouracilFreseniUS Kabi USA, LLC100 × 1500
63323-0117-68FluorouracilFreseniUS Kabi USA, LLC100 × 1500
63323-0117-69FluorouracilFreseniUS Kabi USA, LLC100 × 1500
68001-0524-30FluorouracilBluePoint Laboratories10 × 10500
68001-0524-31FluorouracilBluePoint Laboratories20 × 101000
68001-0525-27FluorouracilBluePoint Laboratories50 × 1250
68001-0525-32FluorouracilBluePoint Laboratories100 × 1500
68001-0627-27FluorouracilBluePoint Laboratories50 × 1250
68001-0628-32FluorouracilBluePoint Laboratories100 × 1500
70700-0186-23FluorouracilXiromed, LLC10 × 10500
70700-0187-23FluorouracilXiromed, LLC20 × 101000
70700-0188-22FluorouracilXiromed, LLC50 × 1250
70700-0189-22FluorouracilXiromed, LLC100 × 1500
71288-0154-76FluorouracilMeitheal Pharmaceuticals Inc.100 × 1500
71288-0170-75FluorouracilMeitheal Pharmaceuticals Inc.50 × 1250

Medically Unlikely Edits (MUE)

CMS does not publish an MUE for J9192 in the 2026 Q4 tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the dose and the units calculation on every claim.

NCCI edits and add-on relationships

No active practitioner PTP pair lists J9192 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

J9192 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

No current Billing and Coding Article lists J9192 in its HCPCS table. Coverage then follows the drug's FDA label, compendia and any National Coverage Determination; check the Medicare Coverage Database before administering off-label.

Common denials for J9192 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks J9192 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

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Frequently asked questions — HCPCS J9192

What does HCPCS code J9192 describe?

J9192 is defined by CMS as "Injection, fluorouracil, 10 mg". Each billing unit represents 10 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J9192 in October 2026?

The ASP-based payment limit is $0.039 per 10 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules.

Which NDCs map to J9192?

The October 2026 ASP crosswalk lists 28 NDCs from 7 labelers: Fluorouracil (Sagent Pharmaceuticals); Fluorouracil (Eugia US LLC); Fluorouracil (Alembic Pharmaceuticals Inc.); Fluorouracil (FreseniUS Kabi USA, LLC). For example NDC 25021-0215-98 is a 50 package equal to 250 billing units. The crosswalk's billing-units-per-package figure converts each package into J9192 units.

Does J9192 have NCCI bundling edits?

No active practitioner PTP pairs list J9192 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-02. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.