RxDoctor Payments Data

HCPCS J1626

Injection, granisetron hydrochloride, 100 mcg

$0.31Medicare-allowed amount per service, averaged across 972,377 services
Providers submitted
$17.07

Asking price, not received

Medicare allowed
$0.31

The fee schedule figure

Medicare paid
$0.25

Balance is patient coinsurance

Providers submitted an average of $17.07 for this code and Medicare allowed $0.3155.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $0.25 (81%); the rest is the patient’s coinsurance and deductible.

Services
972,377

Medicare Part B, 2024

Beneficiaries
28,893
Providers billing it
1,123
Total allowed
$301,437

Services × allowed amount

What Medicare pays for HCPCS J1626

Across 972,377 services billed by 1,123 providers to 28,893 beneficiaries, Medicare allowed an average of $0.31 per service. That is 33.7 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills J1626

SpecialtyServicesBeneficiariesAvg allowedProviders
Hematology-Oncology694,64419,866$0.32737
Medical Oncology192,4686,325$0.31265
Internal Medicine30,2311,048$0.3239
Hematology16,789381$0.3213
Gynecological Oncology16,418443$0.3122
Nurse Practitioner7,990311$0.3121
Hospitalist3,470103$0.313
Physician Assistant3,182102$0.315
Radiation Oncology3,020141$0.319
Hematopoietic Cell Transplantation and Cellular Therapy1,99545$0.322
Obstetrics & Gynecology1,01050$0.332
Gastroenterology46031$0.312
Hospice and Palliative Care31016$0.301
Anesthesiology25019$0.311
Rheumatology14012$0.281

J1626 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
Texas189,643$0.32$0.25276
California97,421$0.32$0.2565
Virginia78,713$0.32$0.25107
Maryland51,591$0.28$0.2247
Florida44,033$0.32$0.2547
Arizona38,390$0.32$0.2532
Arkansas37,550$0.32$0.2518
New York37,522$0.32$0.2546
New Jersey37,005$0.32$0.2521
Pennsylvania34,557$0.33$0.2634
Alabama29,973$0.31$0.2530
Colorado29,605$0.32$0.2542
Illinois26,959$0.32$0.2544
Nevada24,016$0.31$0.2525
Ohio23,530$0.32$0.2529
Georgia19,493$0.32$0.2623
Minnesota18,881$0.31$0.2527
Oregon18,271$0.31$0.2531
Missouri17,760$0.33$0.2629
Tennessee12,581$0.32$0.2523
South Carolina11,560$0.31$0.259
Indiana10,600$0.32$0.258
Washington9,992$0.31$0.2513
Michigan9,650$0.31$0.2516
Kansas9,000$0.31$0.256
Maine8,670$0.32$0.2510
North Carolina5,847$0.31$0.255
Iowa5,730$0.32$0.258
Delaware5,500$0.31$0.247
New Mexico4,350$0.32$0.2512
Nebraska4,130$0.32$0.259
South Dakota3,710$0.32$0.263
Connecticut2,948$0.31$0.255
Alaska2,765$0.32$0.265
Kentucky2,171$0.30$0.263
Louisiana1,510$0.32$0.261
Puerto Rico1,450$0.32$0.251
Rhode Island1,400$0.32$0.251
Mississippi1,320$0.31$0.241
Massachusetts860$0.32$0.251
Vermont770$0.31$0.251
XX560$0.32$0.261
New Hampshire390$0.32$0.251

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.