J2353 HCPCS code: Injection, octreotide, depot form for intramuscular injection, 1 mg
J2353 is the HCPCS Level II code for injection, octreotide, depot form for intramuscular injection, 1 mg. In 2024 Medicare paid an average of $163.94 per service for J2353 across 583,588 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 60 per day on outpatient hospital claims. Medicare volume fell 18% from 2022 to 2024 (709,660 to 583,588 services). In 2024, about 2,837 clinicians billed Medicare for J2353 for 2,645 beneficiaries; Florida, California, Texas accounted for 34% 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 J2353 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,837 |
| Medicare beneficiaries | 2,645 |
| States with claims | 36 |
| Share of services in top 3 states (Florida, California, Texas) | 34% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2353, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 709,660 | 3,094 | $201.61 | $160.73 |
| 2023 | 664,039 | 2,946 | $199.77 | $158.96 |
| 2024 | 583,588 | 2,645 | $206.09 | $163.94 |
States with the most J2353 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 72,945 | $163.39 |
| California | 62,991 | $162.56 |
| Texas | 56,354 | $165.62 |
| Illinois | 32,816 | $163.22 |
| Virginia | 28,232 | $166.26 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 60 | Clinical: Society Comment |
| practitioner claims | 60 | Clinical: Society Comment |
Medicare policy articles for this code
- A56531: Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot) (Palmetto GBA (MAC - Part B))
Covered diagnoses (72 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C25.4 | Malignant neoplasm of endocrine pancreas | 1 |
| C26.0 | Malignant neoplasm of intestinal tract, part unspecified | 1 |
| C37 | Malignant neoplasm of thymus | 1 |
| C7A.010 | Malignant carcinoid tumor of the duodenum | 1 |
| C7A.011 | Malignant carcinoid tumor of the jejunum | 1 |
| C7A.012 | Malignant carcinoid tumor of the ileum | 1 |
| C7A.019 | Malignant carcinoid tumor of the small intestine, unspecified portion | 1 |
| C7A.020 | Malignant carcinoid tumor of the appendix | 1 |
| C7A.021 | Malignant carcinoid tumor of the cecum | 1 |
| C7A.022 | Malignant carcinoid tumor of the ascending colon | 1 |
Showing 10 of 72. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J2353
- 2004-01-01: J2353 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 J2353?
J2353 is the HCPCS Level II code for injection, octreotide, depot form for intramuscular injection, 1 mg. Short descriptor: "Octreotide injection, depot".
How much does Medicare pay for J2353?
In 2024, the average Medicare payment was $163.94 per service (average allowed $206.09).
Does Medicare cover J2353?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J2353?
Medicare policy articles that cite J2353 list 72 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C25.4 (Malignant neoplasm of endocrine pancreas), C26.0 (Malignant neoplasm of intestinal tract, part unspecified), C37 (Malignant neoplasm of thymus). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J2353 can be billed per day?
60 on outpatient hospital claims; 60 on practitioner claims (NCCI medically unlikely edits).
Related J23 codes
- J2300 — Injection, nalbuphine hydrochloride, per 10 mg
- J2305 — Injection, nitroglycerin, 5 mg
- J2310 — Injection, naloxone hydrochloride, per 1 mg
- J2311 — Injection, naloxone hydrochloride (zimhi), 1 mg
- J2312 — Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg
- J2313 — Injection, naloxone hydrochloride (zimhi), 0.01 mg
- J2315 — Injection, naltrexone, depot form, 1 mg
- J2320 — Injection, nandrolone decanoate, up to 50 mg
- J2323 — Injection, natalizumab, 1 mg
- J2325 — Injection, nesiritide, 0.1 mg
- J2326 — Injection, nusinersen, 0.1 mg
- J2327 — Injection, risankizumab-rzaa, intravenous, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J2353
- Watch J2353 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2353
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.