J2469 HCPCS code: Injection, palonosetron hcl, 25 mcg
J2469 is the HCPCS Level II code for injection, palonosetron hcl, 25 mcg. In 2024 Medicare paid an average of $0.71 per service for J2469 across 2,793,665 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 7% from 2022 to 2024 (3,019,652 to 2,793,665 services). In 2024, about 4,727 clinicians billed Medicare for J2469 for 48,290 beneficiaries; Florida, Texas, California accounted for 33% 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 | 2005-01-01 |
| Last action effective | 2024-01-01 |
Who bills J2469 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 4,727 |
| Medicare beneficiaries | 48,290 |
| States with claims | 51 |
| Share of services in top 3 states (Florida, Texas, California) | 33% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2469, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 3,019,652 | 52,721 | $1.01 | $0.81 |
| 2023 | 2,882,015 | 49,877 | $1.03 | $0.81 |
| 2024 | 2,793,665 | 48,290 | $0.89 | $0.71 |
States with the most J2469 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 402,534 | $0.71 |
| Texas | 314,596 | $0.71 |
| California | 214,571 | $0.71 |
| Illinois | 169,202 | $0.71 |
| Arizona | 127,551 | $0.71 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 60 | Prescribing Information |
| practitioner claims | 60 | Prescribing Information |
What changed for J2469
- 2005-01-01: J2469 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 J2469?
J2469 is the HCPCS Level II code for injection, palonosetron hcl, 25 mcg. Short descriptor: "Palonosetron hcl".
How much does Medicare pay for J2469?
In 2024, the average Medicare payment was $0.71 per service (average allowed $0.89).
Does Medicare cover J2469?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2469 can be billed per day?
60 on outpatient hospital claims; 60 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 J2469
- Watch J2469 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2469
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.