J2470 HCPCS code: Injection, pantoprazole sodium, 40 mg
J2470 is the HCPCS Level II code for injection, pantoprazole sodium, 40 mg. In 2024 Medicare paid an average of $3.33 per service for J2470 across 265 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 6 per day on DME suppliers. In 2024, about 108 clinicians billed Medicare for J2470 for 164 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 | 2024-07-01 |
| Last action effective | 2024-07-01 |
Who bills J2470 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 108 |
| Medicare beneficiaries | 164 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2470, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 265 | 164 | $4.18 | $3.33 |
States with the most J2470 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 98 | $3.55 |
| New York | 32 | $5.58 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 6 | Prescribing Information |
| outpatient hospital claims | 6 | Prescribing Information |
| practitioner claims | 6 | Prescribing Information |
What changed for J2470
- 2024-07-01: J2470 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 J2470?
J2470 is the HCPCS Level II code for injection, pantoprazole sodium, 40 mg. Short descriptor: "Inj pantoprazole sodium 40mg".
How much does Medicare pay for J2470?
In 2024, the average Medicare payment was $3.33 per service (average allowed $4.18).
Does Medicare cover J2470?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2470 can be billed per day?
6 on DME suppliers; 6 on outpatient hospital claims; 6 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
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 J2470
- Watch J2470 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2470
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.