J2274 HCPCS code: Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg
J2274 is the HCPCS Level II code for injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg. In 2024 Medicare paid an average of $8.52 per service for J2274 across 150,983 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 100 per day on outpatient hospital claims. Medicare volume fell 28% from 2022 to 2024 (210,151 to 150,983 services). In 2024, about 259 clinicians billed Medicare for J2274 for 1,153 beneficiaries; Florida, Pennsylvania, Kentucky accounted for 64% 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 | 2015-01-01 |
| Last action effective | 2018-01-01 |
Who bills J2274 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 259 |
| Medicare beneficiaries | 1,153 |
| States with claims | 16 |
| Share of services in top 3 states (Florida, Pennsylvania, Kentucky) | 64% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2274, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 210,151 | 1,481 | $12.93 | $10.26 |
| 2023 | 186,290 | 1,361 | $11.67 | $9.22 |
| 2024 | 150,983 | 1,153 | $10.81 | $8.52 |
States with the most J2274 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 52,891 | $8.84 |
| Pennsylvania | 28,305 | $8.86 |
| Kentucky | 11,017 | $8.80 |
| California | 7,853 | $8.77 |
| Texas | 7,679 | $7.67 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 100 | Clinical: Data |
| practitioner claims | 250 | Clinical: Data |
Medicare policy articles for this code
- A52507: External Infusion Pumps - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B))
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B))
Covered diagnoses (2,477 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C91.00 | Acute lymphoblastic leukemia not having achieved remission | 2 |
| C91.01 | Acute lymphoblastic leukemia, in remission | 2 |
| C91.02 | Acute lymphoblastic leukemia, in relapse | 2 |
| A18.01 | Tuberculosis of spine | 1 |
| B02.23 | Postherpetic polyneuropathy | 1 |
| C00.0 | Malignant neoplasm of external upper lip | 1 |
| C00.1 | Malignant neoplasm of external lower lip | 1 |
| C00.3 | Malignant neoplasm of upper lip, inner aspect | 1 |
| C00.4 | Malignant neoplasm of lower lip, inner aspect | 1 |
| C00.6 | Malignant neoplasm of commissure of lip, unspecified | 1 |
Showing 10 of 2,477. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J2274
- 2015-01-01: J2274 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 J2274?
J2274 is the HCPCS Level II code for injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg. Short descriptor: "Inj morphine pf epid ithc".
How much does Medicare pay for J2274?
In 2024, the average Medicare payment was $8.52 per service (average allowed $10.81).
Does Medicare cover J2274?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J2274?
Medicare policy articles that cite J2274 list 2,477 covered ICD-10-CM diagnosis codes across 3 articles. The most cited include C91.00 (Acute lymphoblastic leukemia not having achieved remission), C91.01 (Acute lymphoblastic leukemia, in remission), C91.02 (Acute lymphoblastic leukemia, in relapse). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J2274 can be billed per day?
100 on outpatient hospital claims; 250 on practitioner claims (NCCI medically unlikely edits).
Related J22 codes
- J2210 — Injection, methylergonovine maleate, up to 0.2 mg
- J2212 — Injection, methylnaltrexone, 0.1 mg
- J2246 — Injection, micafungin in sodium (baxter), not therapeutically equivalent to j2248, 1 mg
- J2247 — Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg
- J2248 — Injection, micafungin sodium, 1 mg
- J2249 — Injection, remimazolam, 1 mg
- J2250 — Injection, midazolam hydrochloride, per 1 mg
- J2251 — Injection, midazolam in 0.9% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
- J2252 — Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg
- J2253 — Injection, midazolam (seizalam), 1 mg
- J2260 — Injection, milrinone lactate, 5 mg
- J2265 — Injection, minocycline hydrochloride, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J2274
- Watch J2274 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2274
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.