J2720 HCPCS code: Injection, protamine sulfate, per 10 mg
J2720 is the HCPCS Level II code for injection, protamine sulfate, per 10 mg. In 2024 Medicare paid an average of $1.19 per service for J2720 across 1,964 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 10 per day on outpatient hospital claims. In 2024, about 70 clinicians billed Medicare for J2720 for 563 beneficiaries; Florida, Tennessee, Michigan accounted for 66% of services.
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 | 1997-01-01 |
Who bills J2720 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 70 |
| Medicare beneficiaries | 563 |
| States with claims | 8 |
| Share of services in top 3 states (Florida, Tennessee, Michigan) | 66% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2720, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,972 | 602 | $1.54 | $1.22 |
| 2023 | 2,301 | 671 | $0.90 | $0.71 |
| 2024 | 1,964 | 563 | $1.50 | $1.19 |
States with the most J2720 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 493 | $1.19 |
| Tennessee | 398 | $1.31 |
| Michigan | 300 | $1.18 |
| Illinois | 204 | $1.16 |
| California | 198 | $1.13 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 10 | Clinical: Data |
| practitioner claims | 5 | Prescribing Information |
What changed for J2720
- 1982-01-01: J2720 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 J2720?
J2720 is the HCPCS Level II code for injection, protamine sulfate, per 10 mg. Short descriptor: "Inj protamine sulfate/10 mg".
How much does Medicare pay for J2720?
In 2024, the average Medicare payment was $1.19 per service (average allowed $1.50).
Does Medicare cover J2720?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J2720 can be billed per day?
10 on outpatient hospital claims; 5 on practitioner claims (NCCI medically unlikely edits).
Related J27 codes
- J2700 — Injection, oxacillin sodium, up to 250 mg
- J2704 — Injection, propofol, 10 mg
- J2710 — Injection, neostigmine methylsulfate, up to 0.5 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 J2720
- Watch J2720 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2720
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.