J2430 HCPCS code: Injection, pamidronate disodium, per 30 mg
J2430 is the HCPCS Level II code for injection, pamidronate disodium, per 30 mg. In 2024 Medicare paid an average of $8.93 per service for J2430 across 1,852 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 3 per day on outpatient hospital claims. Medicare volume fell 56% from 2022 to 2024 (4,240 to 1,852 services). In 2024, about 309 clinicians billed Medicare for J2430 for 281 beneficiaries; California, Florida, Virginia accounted for 53% 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 | 1982-01-01 |
| Last action effective | 1997-01-01 |
Who bills J2430 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 309 |
| Medicare beneficiaries | 281 |
| States with claims | 10 |
| Share of services in top 3 states (California, Florida, Virginia) | 53% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2430, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 4,240 | 586 | $10.32 | $7.91 |
| 2023 | 3,281 | 442 | $10.09 | $7.73 |
| 2024 | 1,852 | 281 | $11.55 | $8.93 |
States with the most J2430 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 272 | $8.89 |
| Florida | 235 | $8.83 |
| Virginia | 208 | $9.30 |
| Texas | 175 | $8.90 |
| Tennessee | 104 | $8.59 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 3 | Prescribing Information |
| practitioner claims | 3 | Prescribing Information |
Medicare policy articles for this code
- A56907: Billing and Coding: Bisphosphonate Drug Therapy (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
Covered diagnoses (228 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C50.011 | Malignant neoplasm of nipple and areola, right female breast | 1 |
| C50.012 | Malignant neoplasm of nipple and areola, left female breast | 1 |
| C50.021 | Malignant neoplasm of nipple and areola, right male breast | 1 |
| C50.022 | Malignant neoplasm of nipple and areola, left male breast | 1 |
| C50.111 | Malignant neoplasm of central portion of right female breast | 1 |
| C50.112 | Malignant neoplasm of central portion of left female breast | 1 |
| C50.121 | Malignant neoplasm of central portion of right male breast | 1 |
| C50.122 | Malignant neoplasm of central portion of left male breast | 1 |
| C50.211 | Malignant neoplasm of upper-inner quadrant of right female breast | 1 |
| C50.212 | Malignant neoplasm of upper-inner quadrant of left female breast | 1 |
Showing 10 of 228. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J2430
- 1982-01-01: J2430 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 J2430?
J2430 is the HCPCS Level II code for injection, pamidronate disodium, per 30 mg. Short descriptor: "Pamidronate disodium /30 mg".
How much does Medicare pay for J2430?
In 2024, the average Medicare payment was $8.93 per service (average allowed $11.55).
Does Medicare cover J2430?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J2430?
Medicare policy articles that cite J2430 list 228 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C50.011 (Malignant neoplasm of nipple and areola, right female breast), C50.012 (Malignant neoplasm of nipple and areola, left female breast), C50.021 (Malignant neoplasm of nipple and areola, right male breast). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J2430 can be billed per day?
3 on outpatient hospital claims; 3 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
- J2427 — Injection, paliperidone palmitate extended release (invega hafyera, or invega trinza), 1 mg
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Next steps
- Run a reimbursement report for a device billed under J2430
- Watch J2430 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2430
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.