J2516 HCPCS code: Injection, pentamidine isethionate, 1 mg
J2516 is the HCPCS Level II code for injection, pentamidine isethionate, 1 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
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 | 2026-01-01 |
| Last action effective | 2026-01-01 |
What changed for J2516
- January 2026: Code appears in this HCPCS release
- 2026-01-01: J2516 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 J2516?
J2516 is the HCPCS Level II code for injection, pentamidine isethionate, 1 mg. Short descriptor: "Inj, pentamidine isethionate".
Does Medicare cover J2516?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
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
- J2507 — Injection, pegloticase, 1 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
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 J2516
- Watch J2516 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2516
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.