J2507 HCPCS code: Injection, pegloticase, 1 mg
J2507 is the HCPCS Level II code for injection, pegloticase, 1 mg. In 2024 Medicare paid an average of $2,636.03 per service for J2507 across 73,733 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 8 per day on outpatient hospital claims. Medicare volume rose 26% from 2022 to 2024 (58,508 to 73,733 services). In 2024, about 825 clinicians billed Medicare for J2507 for 957 beneficiaries; Florida, Texas, California accounted for 32% 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 | 2012-01-01 |
| Last action effective | 2012-01-01 |
Who bills J2507 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 825 |
| Medicare beneficiaries | 957 |
| States with claims | 25 |
| Share of services in top 3 states (Florida, Texas, California) | 32% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2507, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 58,508 | 834 | $2,912.05 | $2,324.06 |
| 2023 | 69,327 | 952 | $3,097.34 | $2,467.56 |
| 2024 | 73,733 | 957 | $3,306.82 | $2,636.03 |
States with the most J2507 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 8,306 | $2,660.11 |
| Texas | 7,714 | $2,678.12 |
| California | 6,113 | $2,388.37 |
| Maryland | 5,541 | $2,638.97 |
| Arizona | 3,765 | $2,684.83 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 8 | Prescribing Information |
| practitioner claims | 8 | Prescribing Information |
What changed for J2507
- 2012-01-01: J2507 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 J2507?
J2507 is the HCPCS Level II code for injection, pegloticase, 1 mg. Short descriptor: "Pegloticase injection".
How much does Medicare pay for J2507?
In 2024, the average Medicare payment was $2,636.03 per service (average allowed $3,306.82).
Does Medicare cover J2507?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2507 can be billed per day?
8 on outpatient hospital claims; 8 on practitioner claims (NCCI medically unlikely edits).
Related J25 codes
- J2501 — Injection, paricalcitol, 1 mcg
- J2502 — Injection, pasireotide long acting, 1 mg
- J2503 — Injection, pegaptanib sodium, 0.3 mg
- J2504 — Injection, pegademase bovine, 25 iu
- J2505 — Injection, pegfilgrastim, 6 mg
- J2506 — Injection, pegfilgrastim, excludes biosimilar, 0.5 mg
- J2508 — Injection, pegunigalsidase alfa-iwxj, 1 mg
- J2510 — Injection, penicillin g procaine, aqueous, up to 600,000 units
- J2513 — Injection, pentastarch, 10% solution, 100 ml
- J2515 — Injection, pentobarbital sodium, per 50 mg
- J2540 — Injection, penicillin g potassium, up to 600,000 units
- J2543 — Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)
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 J2507
- Watch J2507 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2507
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.