J0290 HCPCS code: Injection, ampicillin sodium, 500 mg
J0290 is the HCPCS Level II code for injection, ampicillin sodium, 500 mg. In 2024 Medicare paid an average of $0.71 per service for J0290 across 11,111 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 24 per day on outpatient hospital claims. Medicare volume fell 4% from 2022 to 2024 (11,585 to 11,111 services). In 2024, about 160 clinicians billed Medicare for J0290 for 526 beneficiaries; Georgia, Texas, Missouri accounted for 60% 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 | 2000-01-01 |
Who bills J0290 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 160 |
| Medicare beneficiaries | 526 |
| States with claims | 12 |
| Share of services in top 3 states (Georgia, Texas, Missouri) | 60% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0290, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 11,585 | 562 | $0.69 | $0.54 |
| 2023 | 10,948 | 516 | $0.83 | $0.65 |
| 2024 | 11,111 | 526 | $0.90 | $0.71 |
States with the most J0290 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Georgia | 1,753 | $0.65 |
| Texas | 1,121 | $0.73 |
| Missouri | 1,102 | $0.76 |
| Colorado | 1,009 | $0.73 |
| Oklahoma | 678 | $0.71 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 24 | Clinical: Data |
| practitioner claims | 24 | Clinical: Data |
What changed for J0290
- 1984-01-01: J0290 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 J0290?
J0290 is the HCPCS Level II code for injection, ampicillin sodium, 500 mg. Short descriptor: "Ampicillin 500 mg inj".
How much does Medicare pay for J0290?
In 2024, the average Medicare payment was $0.71 per service (average allowed $0.90).
Does Medicare cover J0290?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J0290 can be billed per day?
24 on outpatient hospital claims; 24 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 J0290
- Watch J0290 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0290
Sources: CMS HCPCS Level II release October 2026; 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.