J2791 HCPCS code: Injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu
J2791 is the HCPCS Level II code for injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu. In 2024 Medicare paid an average of $2.89 per service for J2791 across 379 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 15 per day on outpatient hospital claims. Medicare volume fell 42% from 2022 to 2024 (650 to 379 services). In 2024, about 29 clinicians billed Medicare for J2791 for 29 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 | 2008-01-01 |
| Last action effective | 2016-01-01 |
Who bills J2791 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 29 |
| Medicare beneficiaries | 29 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2791, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 650 | 45 | $4.69 | $3.05 |
| 2023 | 529 | 37 | $4.73 | $3.44 |
| 2024 | 379 | 29 | $4.64 | $2.89 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 15 | Clinical: Data |
| practitioner claims | 15 | Clinical: Data |
Medicare policy articles for this code
- A56718: Billing and Coding: Intravenous Immunoglobulin (IVIG) (Palmetto GBA (MAC - Part A, MAC - Part B))
- A57160: Billing and Coding: Immune Thrombocytopenia (ITP) Therapy (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
Covered diagnoses (212 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| D69.3 | Immune thrombocytopenic purpura | 2 |
| A85.8 | Other specified viral encephalitis | 1 |
| B08.3 | Erythema infectiosum [fifth disease] | 1 |
| B20 | Human immunodeficiency virus [HIV] disease | 1 |
| B25.0 | Cytomegaloviral pneumonitis | 1 |
| B25.1 | Cytomegaloviral hepatitis | 1 |
| B25.2 | Cytomegaloviral pancreatitis | 1 |
| B25.8 | Other cytomegaloviral diseases | 1 |
| B25.9 | Cytomegaloviral disease, unspecified | 1 |
| C88.00 | Waldenstrom macroglobulinemia not having achieved remission | 1 |
Showing 10 of 212. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J2791
- 2008-01-01: J2791 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 J2791?
J2791 is the HCPCS Level II code for injection, rho(d) immune globulin (human), (rhophylac), intramuscular or intravenous, 100 iu. Short descriptor: "Rhophylac injection".
How much does Medicare pay for J2791?
In 2024, the average Medicare payment was $2.89 per service (average allowed $4.64).
Does Medicare cover J2791?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J2791?
Medicare policy articles that cite J2791 list 212 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include D69.3 (Immune thrombocytopenic purpura), A85.8 (Other specified viral encephalitis), B08.3 (Erythema infectiosum [fifth disease]). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J2791 can be billed per day?
15 on outpatient hospital claims; 15 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
- 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
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Next steps
- Run a reimbursement report for a device billed under J2791
- Watch J2791 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2791
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.