J2760 HCPCS code: Injection, phentolamine mesylate, up to 5 mg
J2760 is the HCPCS Level II code for injection, phentolamine mesylate, up to 5 mg. In 2024 Medicare paid an average of $134.31 per service for J2760 across 795 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 2 per day on outpatient hospital claims. Medicare volume rose 22% from 2022 to 2024 (649 to 795 services). In 2024, about 102 clinicians billed Medicare for J2760 for 560 beneficiaries; Virginia, California, Arizona accounted for 82% 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 J2760 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 102 |
| Medicare beneficiaries | 560 |
| States with claims | 9 |
| Share of services in top 3 states (Virginia, California, Arizona) | 82% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2760, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 649 | 576 | $239.89 | $190.12 |
| 2023 | 829 | 655 | $224.51 | $176.81 |
| 2024 | 795 | 560 | $170.47 | $134.31 |
States with the most J2760 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Virginia | 418 | $94.28 |
| California | 136 | $245.01 |
| Arizona | 54 | $24.25 |
| Utah | 36 | $111.07 |
| Texas | 28 | $195.17 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 2 | Prescribing Information |
| practitioner claims | 2 | Prescribing Information |
What changed for J2760
- 1982-01-01: J2760 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 J2760?
J2760 is the HCPCS Level II code for injection, phentolamine mesylate, up to 5 mg. Short descriptor: "Phentolaine mesylate inj".
How much does Medicare pay for J2760?
In 2024, the average Medicare payment was $134.31 per service (average allowed $170.47).
Does Medicare cover J2760?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J2760 can be billed per day?
2 on outpatient hospital claims; 2 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
- 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
- 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
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 J2760
- Watch J2760 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2760
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.