J2406 HCPCS code: Injection, oritavancin (kimyrsa), 10 mg
J2406 is the HCPCS Level II code for injection, oritavancin (kimyrsa), 10 mg. In 2024 Medicare paid an average of $32.15 per service for J2406 across 152,147 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 120 per day on outpatient hospital claims. Medicare volume rose 43% from 2022 to 2024 (106,306 to 152,147 services). In 2024, about 161 clinicians billed Medicare for J2406 for 807 beneficiaries; Florida, Texas, Georgia accounted for 77% 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 | 2021-10-01 |
| Last action effective | 2021-10-01 |
Who bills J2406 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 161 |
| Medicare beneficiaries | 807 |
| States with claims | 9 |
| Share of services in top 3 states (Florida, Texas, Georgia) | 77% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2406, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 106,306 | 568 | $40.82 | $32.54 |
| 2023 | 136,047 | 724 | $40.40 | $32.20 |
| 2024 | 152,147 | 807 | $40.35 | $32.15 |
States with the most J2406 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 62,981 | $32.38 |
| Texas | 27,900 | $31.64 |
| Georgia | 18,760 | $32.34 |
| Michigan | 11,400 | $31.74 |
| Illinois | 6,840 | $32.04 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 120 | Prescribing Information |
| practitioner claims | 120 | Prescribing Information |
What changed for J2406
- 2021-10-01: J2406 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 J2406?
J2406 is the HCPCS Level II code for injection, oritavancin (kimyrsa), 10 mg. Short descriptor: "Injection, oritavancin 10 mg".
How much does Medicare pay for J2406?
In 2024, the average Medicare payment was $32.15 per service (average allowed $40.35).
Does Medicare cover J2406?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2406 can be billed per day?
120 on outpatient hospital claims; 120 on practitioner claims (NCCI medically unlikely edits).
Related J24 codes
- J2400 — Injection, chloroprocaine hydrochloride, per 30 ml
- J2401 — Injection, chloroprocaine hydrochloride, per 1 mg
- J2402 — Injection, chloroprocaine hydrochloride (clorotekal), per 1 mg
- J2403 — Chloroprocaine hcl ophthalmic, 3% gel, 1 mg
- J2404 — Injection, nicardipine, 0.1 mg
- J2405 — Injection, ondansetron hydrochloride, per 1 mg
- J2407 — Injection, oritavancin (orbactiv), 10 mg
- J2410 — Injection, oxymorphone hcl, up to 1 mg
- J2425 — Injection, palifermin, 50 micrograms
- J2426 — Injection, paliperidone palmitate extended release (invega sustenna), 1 mg
- J2427 — Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg
- J2428 — Injection, paliperidone palmitate extended release (erzofri), 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 J2406
- Watch J2406 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2406
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.