J0692 HCPCS code: Injection, cefepime hydrochloride, 500 mg
J0692 is the HCPCS Level II code for injection, cefepime hydrochloride, 500 mg. In 2024 Medicare paid an average of $0.99 per service for J0692 across 139,191 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 DME suppliers. Medicare volume fell 22% from 2022 to 2024 (179,592 to 139,191 services). In 2024, about 776 clinicians billed Medicare for J0692 for 2,065 beneficiaries; Florida, Texas, Colorado accounted for 70% 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 | 2002-01-01 |
| Last action effective | 2002-01-01 |
Who bills J0692 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 776 |
| Medicare beneficiaries | 2,065 |
| States with claims | 29 |
| Share of services in top 3 states (Florida, Texas, Colorado) | 70% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0692, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 179,592 | 2,362 | $1.74 | $1.38 |
| 2023 | 151,786 | 2,233 | $1.23 | $0.98 |
| 2024 | 139,191 | 2,065 | $1.25 | $0.99 |
States with the most J0692 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 65,014 | $1.00 |
| Texas | 25,820 | $0.99 |
| Colorado | 5,884 | $1.01 |
| New Jersey | 4,906 | $0.99 |
| Georgia | 4,267 | $1.00 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 12 | Prescribing Information |
| outpatient hospital claims | 12 | Prescribing Information |
| practitioner claims | 12 | Prescribing Information |
What changed for J0692
- 2002-01-01: J0692 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 J0692?
J0692 is the HCPCS Level II code for injection, cefepime hydrochloride, 500 mg. Short descriptor: "Cefepime hcl for injection".
How much does Medicare pay for J0692?
In 2024, the average Medicare payment was $0.99 per service (average allowed $1.25).
Does Medicare cover J0692?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0692 can be billed per day?
12 on DME suppliers; 12 on outpatient hospital claims; 12 on practitioner claims (NCCI medically unlikely edits).
Related J06 codes
- J0600 — Injection, edetate calcium disodium, up to 1000 mg
- J0601 — Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)
- J0602 — Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for esrd on dialysis)
- J0603 — Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for esrd on dialysis)
- J0604 — Cinacalcet, oral, 1 mg, (for esrd on dialysis)
- J0605 — Sucroferric oxyhydroxide, oral, 5 mg (for esrd on dialysis)
- J0606 — Injection, etelcalcetide, 0.1 mg
- J0607 — Lanthanum carbonate, oral, 5 mg (for esrd on dialysis)
- J0608 — Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to j0607 (for esrd on dialysis)
- J0609 — Ferric citrate, oral, 3 mg ferric iron, (for esrd on dialysis)
- J0610 — Injection, calcium gluconate (fresenius kabi), per 10 ml
- J0611 — Injection, calcium gluconate (wg critical care), per 10 ml
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J0692
- Watch J0692 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0692
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.