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HCPCS J1645

Excluded from PFS

J1645 · PFS Q1 2013 · Historical

Status E is not separately payable under the PFS.

View applicable payment rules
View CMS source and method

Not at a published national rate. HCPCS J1645 carries status E (excluded) in the Q1 2013 release. A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. Treat the blank amount as unpriced, not as $0.

PFS status evidence

Physician relative value file (Q1 2013) · rvu13a.zip (PPRRVU13.csv row 2,391)
Inspect PFS status evidence
Code
J1645
Release
Q1 2013, revision 1
Result
Excluded from PFS

Citations

  • Establishes the PFS status (E) and the resulting pathway for this code: excluded from pfs.

    Physician relative value file (PPRRVU)

    Q1 2013 · revision 1

    Latest revision of this release

    Release period: January 1 – March 31, 2013

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    Record details PPRRVU13.csv in rvu13a.zip (row 2,391)
    hcpcs (col 1)
    J1645
    modifier (col 2)
    blank
    status_code (col 4)
    E

    SHA-256: a84cdae37ebaadbaf680d8ea6051f442d6e61fb44436ca61dc94a43051d877e8

    Original source file

Compact facts

Why is there no national PFS amount for J1645?

Its status indicator is E (excluded). A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. Status E is not separately payable under the PFS.

About this code

Dalteparin sodium

Payment considerations Copy link

Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.

Other payment indicators (10)

Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.

Payment rules

Global period: what J1645's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Can you bill it with another code? Copy link

Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit between it and J1645.

See every current NCCI pair for J1645 →

Common payment questions Copy link

Why would a Medicare claim for J1645 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

  • Its status indicator is E (excluded)—A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. See status indicators

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

History

Rate history by release Copy link

National non-facility amount for J1645 across quarterly releases.

Release Status Non-facility Facility
Q4 2026 takes effect Oct 1, 2026 E — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 E — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 E — —
When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Usage & related

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q1 2013 release (effective January 2013). National baselines use GPCI 1.000 and exclude sequestration. Status and payment instructions determine whether a national amount is established; blank RVUs stay blank. Releases are immutable: historical evidence remains tied to the specified release. CMS owns the code description shown for HCPCS Level II codes. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.

Physician relative value file (Q1 2013) · rvu13a.zip (PPRRVU13.csv row 2,391)

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

This citation identifies the source release, so its evidence remains reproducible after a newer release lands.

HCPCS J1645 National PFS baseline: No national PFS rate (Q1 2013; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/hcpcs/J1645/2013/A