How much does Medicare pay for HCPCS J1642?

Medicare allowed an average of $0.02 per service and paid $0.01 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1.70, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code J1642?

Injection, heparin sodium, (heparin lock flush), per 10 units. It was billed 283,739 times to 1,346 Medicare beneficiaries by 53 providers in 2024.

Which specialty bills J1642 most?

Hematology-Oncology, with 225,344 services from 39 clinicians. Next are Family Practice, Medical Oncology, Hematology.

HCPCS J1642

Injection, heparin sodium, (heparin lock flush), per 10 units

$0.02Medicare-allowed amount per service, averaged across 283,739 services

Providers submitted

$1.70

Asking price, not received

Medicare allowed

$0.02

The fee schedule figure

Medicare paid

$0.01

Balance is patient coinsurance

Providers submitted an average of $1.70 for this code and Medicare allowed $0.02 — 85.0× 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 $0.01 (50%); the rest is the patient’s coinsurance and deductible.

Services: 283,739
Beneficiaries: 1,346
Providers billing it: 53
Total allowed: $5,675

What Medicare pays for HCPCS J1642

Across 283,739 services billed by 53 providers to 1,346 beneficiaries, Medicare allowed an average of $0.02 per service. That is 210.8 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 J1642

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hematology-Oncology	225,344	1,007	$0.02	39
Family Practice	23,831	60	$0.02	4
Medical Oncology	17,990	89	$0.02	3
Hematology	10,460	63	$0.02	2
Gynecological Oncology	3,001	27	$0.02	2
Internal Medicine	2,430	11	$0.02	1
Infectious Disease	635	41	$0.02	1
Cardiology	48	48	$0.02	1

J1642 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.

State	Services	Allowed	Standardized pmt	Providers
California	150,458	$0.02	$0.01	32
Arizona	55,502	$0.02	$0.01	9
South Carolina	32,031	$0.02	$0.01	2
Washington	18,750	$0.02	$0.01	1
South Dakota	17,100	$0.02	$0.01	2
Florida	5,150	$0.02	$0.01	4
North Carolina	4,748	$0.02	$0.01	3

Related codes

J1602Injection, golimumab, 1 mg, for intravenous use$11.35
J1627Injection, granisetron, extended-release, 0.1 mg$5.48
J1626Injection, granisetron hydrochloride, 100 mcg$0.31
J1644Injection, heparin sodium, per 1000 units$0.24
J1611Injection, glucagon hydrochloride (fresenius kabi), not therapeuticall$120.29
J1610Injection, glucagon hydrochloride, per 1 mg$185.52

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.