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HCPCS J7191

Priced under CLFS

J7191 · PFS Q1 2015 · Historical

Status X is not separately payable under the PFS.

View applicable payment rules
View CMS source and method

HCPCS J7191 has no published national rate. It carries status X (statutory exclusion) in the Q1 2015 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.

PFS status evidence

Physician relative value file (Q1 2015) · rvu15a.zip (PPRRVU15_V1223c.csv row 2,816)
Inspect PFS status evidence
Code
J7191
Release
Q1 2015, revision 1
Result
Priced under CLFS

Citations

  • Shows this code’s PFS status (X). Result: Priced under CLFS.

    Physician relative value file (PPRRVU)

    Q1 2015 · revision 1

    Latest revision of this release

    Release period: January 1 – March 31, 2015

    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 PPRRVU15_V1223c.csv in rvu15a.zip (row 2,816)
    hcpcs (col 1)
    J7191
    modifier (col 2)
    blank
    status_code (col 4)
    X

    SHA-256: d600c52a7d5f75737599c9a879cc0ffc8c85766bee82e9e2eadf49af364314d2

    Original source file

Plain-text summary

Why is there no national PFS amount for J7191?

Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. Status X is not separately payable under the PFS.

About this code

Factor viii (porcine)

Payment considerations Copy link

Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.

Other fee-schedule routing Applies
Other payment indicators (9)

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, Contractor pricing: Does not apply.

Why would a Medicare claim for J7191 be denied or paid less?

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

  • Its status indicator is X (statutory exclusion)—The statutory definition of physician services does not include this item. 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.

Which billing rules and modifiers apply? Copy link

Global period: what J7191'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

Check a pair of codes 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 for the pair.

See every current NCCI pair for J7191 →

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for J7191 across quarterly releases.

Release Status Office Facility
Q4 2026 takes effect Oct 1, 2026 X — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 X — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 X — —
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 and related codes Copy link

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q1 2015 release (effective January 2015). National baselines use GPCI 1.000 and exclude sequestration. Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. CMS owns the code description shown for HCPCS Level II codes. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.

Physician relative value file (Q1 2015) · rvu15a.zip (PPRRVU15_V1223c.csv row 2,816)

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

Cite this rate

The citation names the release, so anyone can check it even after CMS publishes a newer one.

HCPCS J7191 National PFS baseline: No national PFS rate (Q1 2015; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/hcpcs/J7191/2015/A