J2704 HCPCS code: Injection, propofol, 10 mg
J2704 is the HCPCS Level II code for injection, propofol, 10 mg. In 2024 Medicare paid an average of $0.08 per service for J2704 across 768,678 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 400 per day on outpatient hospital claims. Medicare volume fell 19% from 2022 to 2024 (947,726 to 768,678 services). In 2024, about 795 clinicians billed Medicare for J2704 for 30,073 beneficiaries; New York, Illinois, Texas accounted for 61% 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 | 2015-01-01 |
| Last action effective | 2015-01-01 |
Who bills J2704 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 795 |
| Medicare beneficiaries | 30,073 |
| States with claims | 38 |
| Share of services in top 3 states (New York, Illinois, Texas) | 61% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2704, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 947,726 | 37,835 | $0.13 | $0.10 |
| 2023 | 981,576 | 37,577 | $0.11 | $0.09 |
| 2024 | 768,678 | 30,073 | $0.11 | $0.08 |
States with the most J2704 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 303,675 | $0.08 |
| Illinois | 92,823 | $0.08 |
| Texas | 71,693 | $0.08 |
| Florida | 48,757 | $0.08 |
| Massachusetts | 30,770 | $0.07 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 400 | Clinical: Data |
| practitioner claims | 80 | Clinical: Data |
What changed for J2704
- 2015-01-01: J2704 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 J2704?
J2704 is the HCPCS Level II code for injection, propofol, 10 mg. Short descriptor: "Inj, propofol, 10 mg".
How much does Medicare pay for J2704?
In 2024, the average Medicare payment was $0.08 per service (average allowed $0.11).
Does Medicare cover J2704?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2704 can be billed per day?
400 on outpatient hospital claims; 80 on practitioner claims (NCCI medically unlikely edits).
Related J27 codes
- J2700 — Injection, oxacillin sodium, up to 250 mg
- J2710 — Injection, neostigmine methylsulfate, up to 0.5 mg
- J2720 — Injection, protamine sulfate, per 10 mg
- J2724 — Injection, protein c concentrate, intravenous, human, 10 iu
- J2725 — Injection, protirelin, per 250 mcg
- J2730 — Injection, pralidoxime chloride, up to 1 gm
- J2760 — Injection, phentolamine mesylate, up to 5 mg
- J2765 — Injection, metoclopramide hcl, up to 10 mg
- J2770 — Injection, quinupristin/dalfopristin, 500 mg (150/350)
- J2777 — Injection, faricimab-svoa, 0.1 mg
- J2778 — Injection, ranibizumab, 0.1 mg
- J2779 — Injection, ranibizumab, via intravitreal implant (susvimo), 0.1 mg
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Next steps
- Run a reimbursement report for a device billed under J2704
- Watch J2704 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2704
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.