J2471 HCPCS code: Injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg
J2471 is the HCPCS Level II code for injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg. In 2024 Medicare paid an average of $3.94 per service for J2471 across 441 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 7 clinicians billed Medicare for J2471 for 36 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 J2471 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 7 |
| Medicare beneficiaries | 36 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2471, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 441 | 36 | $4.94 | $3.94 |
States with the most J2471 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New Jersey | 415 | $3.89 |
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 J2471
- 2024-07-01: J2471 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 J2471?
J2471 is the HCPCS Level II code for injection, pantoprazole (hikma), not therapeutically equivalent to j2470, 40 mg. Short descriptor: "Inj pantoprazole(hikma) 40mg".
How much does Medicare pay for J2471?
In 2024, the average Medicare payment was $3.94 per service (average allowed $4.94).
Does Medicare cover J2471?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2471 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 J2471
- Watch J2471 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2471
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.