J0595 HCPCS code: Injection, butorphanol tartrate, 1 mg
J0595 is the HCPCS Level II code for injection, butorphanol tartrate, 1 mg. In 2024 Medicare paid an average of $2.32 per service for J0595 across 473 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 12 per day on outpatient hospital claims. Medicare volume fell 81% from 2022 to 2024 (2,512 to 473 services). In 2024, about 75 clinicians billed Medicare for J0595 for 108 beneficiaries; Alabama, Mississippi, Texas accounted for 83% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2004-01-01 |
| Last action effective | 2004-01-01 |
Who bills J0595 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 75 |
| Medicare beneficiaries | 108 |
| States with claims | 5 |
| Share of services in top 3 states (Alabama, Mississippi, Texas) | 83% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0595, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 2,512 | 364 | $2.68 | $2.00 |
| 2023 | 695 | 159 | $3.22 | $2.18 |
| 2024 | 473 | 108 | $3.21 | $2.32 |
States with the most J0595 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Alabama | 102 | $2.08 |
| Mississippi | 84 | $2.52 |
| Texas | 69 | $1.76 |
| Arkansas | 32 | $2.51 |
| Georgia | 19 | $2.40 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 12 | Clinical: Data |
| practitioner claims | 8 | Clinical: Data |
What changed for J0595
- 2004-01-01: J0595 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 J0595?
J0595 is the HCPCS Level II code for injection, butorphanol tartrate, 1 mg. Short descriptor: "Butorphanol tartrate 1 mg".
How much does Medicare pay for J0595?
In 2024, the average Medicare payment was $2.32 per service (average allowed $3.21).
Does Medicare cover J0595?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0595 can be billed per day?
12 on outpatient hospital claims; 8 on practitioner claims (NCCI medically unlikely edits).
Related J05 codes
- J0500 — Injection, dicyclomine hcl, up to 20 mg
- J0515 — Injection, benztropine mesylate, per 1 mg
- J0517 — Injection, benralizumab, 1 mg
- J0520 — Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg
- J0525 — Injection, cefotetan disodium, 10 mg
- J0558 — Injection, penicillin g benzathine and penicillin g procaine, 100,000 units
- J0561 — Injection, penicillin g benzathine, 100,000 units
- J0565 — Injection, bezlotoxumab, 10 mg
- J0567 — Injection, cerliponase alfa, 1 mg
- J0570 — Buprenorphine implant, 74.2 mg
- J0571 — Buprenorphine, oral, 1 mg
- J0572 — Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
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Next steps
- Run a reimbursement report for a device billed under J0595
- Watch J0595 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0595
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.