J2597 HCPCS code: Injection, desmopressin acetate, per 1 mcg
J2597 is the HCPCS Level II code for injection, desmopressin acetate, per 1 mcg. In 2024 Medicare paid an average of $4.39 per service for J2597 across 5,135 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 45 per day on outpatient hospital claims. Medicare volume fell 7% from 2022 to 2024 (5,493 to 5,135 services). In 2024, about 166 clinicians billed Medicare for J2597 for 157 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 1996-01-01 |
| Last action effective | 1997-01-01 |
Who bills J2597 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 166 |
| Medicare beneficiaries | 157 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2597, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 5,493 | 153 | $7.97 | $6.11 |
| 2023 | 6,573 | 158 | $6.84 | $5.28 |
| 2024 | 5,135 | 157 | $5.75 | $4.39 |
States with the most J2597 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 1,010 | $4.41 |
| Florida | 927 | $4.47 |
| California | 884 | $4.49 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 45 | Prescribing Information |
| practitioner claims | 45 | Prescribing Information |
What changed for J2597
- 1996-01-01: J2597 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 J2597?
J2597 is the HCPCS Level II code for injection, desmopressin acetate, per 1 mcg. Short descriptor: "Inj desmopressin acetate".
How much does Medicare pay for J2597?
In 2024, the average Medicare payment was $4.39 per service (average allowed $5.75).
Does Medicare cover J2597?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J2597 can be billed per day?
45 on outpatient hospital claims; 45 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
- 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
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Next steps
- Run a reimbursement report for a device billed under J2597
- Watch J2597 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2597
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.