J2690 HCPCS code: Injection, procainamide hcl, up to 1 gm
J2690 is the HCPCS Level II code for injection, procainamide hcl, up to 1 gm. In 2022 Medicare paid an average of $25.42 per service for J2690 across 165 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 4 per day on outpatient hospital claims. In 2022, about 5 clinicians billed Medicare for J2690 for 79 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 | 1982-01-01 |
| Last action effective | 2024-01-01 |
Who bills J2690 (2022)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 5 |
| Medicare beneficiaries | 79 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2690, 2022–2022
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 165 | 79 | $33.15 | $25.42 |
States with the most J2690 services (2022)
| State | Services | Avg. paid |
|---|---|---|
| California | 149 | $26.39 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 4 | Prescribing Information |
| practitioner claims | 4 | Clinical: Data |
What changed for J2690
- 1982-01-01: J2690 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 J2690?
J2690 is the HCPCS Level II code for injection, procainamide hcl, up to 1 gm. Short descriptor: "Procainamide hcl injection".
How much does Medicare pay for J2690?
In 2022, the average Medicare payment was $25.42 per service (average allowed $33.15).
Does Medicare cover J2690?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J2690 can be billed per day?
4 on outpatient hospital claims; 4 on practitioner claims (NCCI medically unlikely edits).
Related J26 codes
- J2601 — Injection, vasopressin (baxter), 1 unit
- J2650 — Injection, prednisolone acetate, up to 1 ml
- J2670 — Injection, tolazoline hcl, up to 25 mg
- J2675 — Injection, progesterone, per 50 mg
- J2679 — Injection, fluphenazine hcl, 1.25 mg
- J2680 — Injection, fluphenazine decanoate, up to 25 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 J2690
- Watch J2690 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2690
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.