J1790 HCPCS code: Injection, droperidol, up to 5 mg
J1790 is the HCPCS Level II code for injection, droperidol, up to 5 mg. In 2024 Medicare paid an average of $5.90 per service for J1790 across 37 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 2 per day on outpatient hospital claims. Medicare volume rose 37% from 2022 to 2024 (27 to 37 services). In 2024, about 27 clinicians billed Medicare for J1790 for 21 beneficiaries.
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 | 1982-01-01 |
| Last action effective | 1997-01-01 |
Who bills J1790 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 27 |
| Medicare beneficiaries | 21 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1790, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 27 | 25 | $7.05 | $5.63 |
| 2023 | 34 | 27 | $6.81 | $5.43 |
| 2024 | 37 | 21 | $7.38 | $5.90 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Prescribing Information |
| practitioner claims | 2 | Prescribing Information |
What changed for J1790
- 1982-01-01: J1790 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 J1790?
J1790 is the HCPCS Level II code for injection, droperidol, up to 5 mg. Short descriptor: "Droperidol injection".
How much does Medicare pay for J1790?
In 2024, the average Medicare payment was $5.90 per service (average allowed $7.38).
Does Medicare cover J1790?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1790 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related J17 codes
- J1700 — Injection, hydrocortisone acetate, up to 25 mg
- J1710 — Injection, hydrocortisone sodium phosphate, up to 50 mg
- J1720 — Injection, hydrocortisone sodium succinate, up to 100 mg
- J1725 — Injection, hydroxyprogesterone caproate, 1 mg
- J1726 — Injection, hydroxyprogesterone caproate, (makena), 10 mg
- J1729 — Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg
- J1730 — Injection, diazoxide, up to 300 mg
- J1738 — Injection, meloxicam, 1 mg
- J1740 — Injection, ibandronate sodium, 1 mg
- J1741 — Injection, ibuprofen, 100 mg
- J1742 — Injection, ibutilide fumarate, 1 mg
- J1743 — Injection, idursulfase, 1 mg
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 J1790
- Watch J1790 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1790
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.