J0280 HCPCS code: Injection, aminophyllin, up to 250 mg
J0280 is the HCPCS Level II code for injection, aminophyllin, up to 250 mg. In 2024 Medicare paid an average of $6.17 per service for J0280 across 43,403 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 10 per day on outpatient hospital claims. Medicare volume fell 19% from 2022 to 2024 (53,404 to 43,403 services). In 2024, about 2,526 clinicians billed Medicare for J0280 for 37,960 beneficiaries; New York, California, Florida accounted for 43% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 1984-01-01 |
| Last action effective | 1997-01-01 |
Who bills J0280 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,526 |
| Medicare beneficiaries | 37,960 |
| States with claims | 41 |
| Share of services in top 3 states (New York, California, Florida) | 43% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0280, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 53,404 | 48,287 | $8.22 | $6.54 |
| 2023 | 46,331 | 41,646 | $8.22 | $6.54 |
| 2024 | 43,403 | 37,960 | $7.76 | $6.17 |
States with the most J0280 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 7,414 | $5.89 |
| California | 5,593 | $6.41 |
| Florida | 5,426 | $5.89 |
| Maryland | 3,586 | $6.68 |
| New Jersey | 3,142 | $6.29 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 10 | Prescribing Information |
| practitioner claims | 7 | Prescribing Information |
Medicare policy articles for this code
- A54768: Billing and Coding: Cardiac Blood Pool Imaging (Multiple Gated Acquisition Scanning- MUGA, Ventriculography) When Performed in Conjunction with Cardiotoxic Chemotherapy (Palmetto GBA (MAC - Part A, MAC - Part B))
- A56476: Billing and Coding: Cardiac Radionuclide Imaging (Palmetto GBA (MAC - Part A, MAC - Part B))
- A56476: Billing and Coding: Cardiac Radionuclide Imaging (Palmetto GBA (MAC - Part A, MAC - Part B))
- A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B))
- A56625: Billing and Coding: Echocardiography (Palmetto GBA (MAC - Part A, MAC - Part B))
- A56781: Billing and Coding: Transthoracic Echocardiography (TTE) (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A57306: Billing and Coding: Transthoracic Echocardiography (TTE) (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
Covered diagnoses (3,704 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| T45.1X5A | Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter | 5 |
| T45.1X5S | Adverse effect of antineoplastic and immunosuppressive drugs, sequela | 5 |
| Z01.89 | Encounter for other specified special examinations | 5 |
| A18.84 | Tuberculosis of heart | 4 |
| C38.0 | Malignant neoplasm of heart | 4 |
| C45.2 | Mesothelioma of pericardium | 4 |
| G45.1 | Carotid artery syndrome (hemispheric) | 4 |
| G45.2 | Multiple and bilateral precerebral artery syndromes | 4 |
| G45.8 | Other transient cerebral ischemic attacks and related syndromes | 4 |
| G45.9 | Transient cerebral ischemic attack, unspecified | 4 |
Showing 10 of 3,704. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J0280
- 1984-01-01: J0280 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J0280?
J0280 is the HCPCS Level II code for injection, aminophyllin, up to 250 mg. Short descriptor: "Aminophyllin 250 mg inj".
How much does Medicare pay for J0280?
In 2024, the average Medicare payment was $6.17 per service (average allowed $7.76).
Does Medicare cover J0280?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J0280?
Medicare policy articles that cite J0280 list 3,704 covered ICD-10-CM diagnosis codes across 7 articles. The most cited include T45.1X5A (Adverse effect of antineoplastic and immunosuppressive drugs, initial encounter), T45.1X5S (Adverse effect of antineoplastic and immunosuppressive drugs, sequela), Z01.89 (Encounter for other specified special examinations). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J0280 can be billed per day?
10 on outpatient hospital claims; 7 on practitioner claims (NCCI medically unlikely edits).
Related J02 codes
- J0200 — Injection, alatrofloxacin mesylate, 100 mg
- J0202 — Injection, alemtuzumab, 1 mg
- J0205 — Injection, alglucerase, per 10 units
- J0206 — Injection, allopurinol sodium, 1 mg
- J0207 — Injection, amifostine, 500 mg
- J0208 — Injection, sodium thiosulfate (pedmark), 100 mg
- J0209 — Injection, sodium thiosulfate (hope), 100 mg
- J0210 — Injection, methyldopate hcl, up to 250 mg
- J0211 — Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)
- J0215 — Injection, alefacept, 0.5 mg
- J0216 — Injection, alfentanil hydrochloride, 500 micrograms
- J0217 — Injection, velmanase alfa-tycv, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J0280
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- Build a full Medicare revenue model for J0280
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.