J2427 HCPCS code: Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg
J2427 is the HCPCS Level II code for injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg. In 2024 Medicare paid an average of $6.36 per service for J2427 across 43,929 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 1560 per day on outpatient hospital claims. Medicare volume rose 372% from 2023 to 2024 (9,300 to 43,929 services). In 2024, about 72 clinicians billed Medicare for J2427 for 70 beneficiaries.
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 | 2023-07-01 |
| Last action effective | 2023-07-01 |
Who bills J2427 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 72 |
| Medicare beneficiaries | 70 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2427, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 9,300 | 23 | $6.37 | $5.07 |
| 2024 | 43,929 | 70 | $8.01 | $6.36 |
States with the most J2427 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 4,116 | $9.71 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1560 | Prescribing Information |
| practitioner claims | 1560 | Prescribing Information |
What changed for J2427
- 2023-07-01: J2427 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 J2427?
J2427 is the HCPCS Level II code for injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg. Short descriptor: "Inj, invega hafyera/trinza".
How much does Medicare pay for J2427?
In 2024, the average Medicare payment was $6.36 per service (average allowed $8.01).
Does Medicare cover J2427?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2427 can be billed per day?
1560 on outpatient hospital claims; 1560 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
- 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
- J2428 — Injection, paliperidone palmitate extended release (erzofri), 1 mg
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Next steps
- Run a reimbursement report for a device billed under J2427
- Watch J2427 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2427
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.