J2407 HCPCS code: Injection, oritavancin (orbactiv), 10 mg
J2407 is the HCPCS Level II code for injection, oritavancin (orbactiv), 10 mg. In 2024 Medicare paid an average of $21.53 per service for J2407 across 22,372 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 120 per day on outpatient hospital claims. Medicare volume fell 50% from 2022 to 2024 (44,320 to 22,372 services). In 2024, about 51 clinicians billed Medicare for J2407 for 118 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 | 2016-01-01 |
| Last action effective | 2021-10-01 |
Who bills J2407 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 51 |
| Medicare beneficiaries | 118 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2407, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 44,320 | 238 | $24.40 | $19.54 |
| 2023 | 11,580 | 81 | $26.34 | $20.97 |
| 2024 | 22,372 | 118 | $27.02 | $21.53 |
States with the most J2407 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 7,080 | $21.52 |
| Georgia | 5,040 | $21.86 |
| Oklahoma | 2,172 | $20.76 |
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 J2407
- 2016-01-01: J2407 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 J2407?
J2407 is the HCPCS Level II code for injection, oritavancin (orbactiv), 10 mg. Short descriptor: "Injection, oritavancin".
How much does Medicare pay for J2407?
In 2024, the average Medicare payment was $21.53 per service (average allowed $27.02).
Does Medicare cover J2407?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J2407 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
- J2406 — Injection, oritavancin (kimyrsa), 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
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Next steps
- Run a reimbursement report for a device billed under J2407
- Watch J2407 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2407
Sources: CMS HCPCS Level II release October 2026; 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.