J2916 HCPCS code: Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg
J2916 is the HCPCS Level II code for injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg. In 2024 Medicare paid an average of $1.66 per service for J2916 across 116,975 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 20 per day on outpatient hospital claims. Medicare volume fell 3% from 2022 to 2024 (120,448 to 116,975 services). In 2024, about 767 clinicians billed Medicare for J2916 for 2,258 beneficiaries; New Jersey, New York, Florida accounted for 54% 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 | 2003-01-01 |
| Last action effective | 2003-01-01 |
Who bills J2916 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 767 |
| Medicare beneficiaries | 2,258 |
| States with claims | 20 |
| Share of services in top 3 states (New Jersey, New York, Florida) | 54% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2916, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 120,448 | 2,167 | $1.89 | $1.47 |
| 2023 | 120,472 | 2,190 | $2.07 | $1.61 |
| 2024 | 116,975 | 2,258 | $2.14 | $1.66 |
States with the most J2916 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New Jersey | 24,275 | $1.68 |
| New York | 23,512 | $1.63 |
| Florida | 14,173 | $1.66 |
| Texas | 12,509 | $1.68 |
| Maryland | 11,152 | $1.70 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 20 | Clinical: Data |
| practitioner claims | 20 | Clinical: Data |
What changed for J2916
- 2003-01-01: J2916 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 J2916?
J2916 is the HCPCS Level II code for injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg. Short descriptor: "Na ferric gluconate complex".
How much does Medicare pay for J2916?
In 2024, the average Medicare payment was $1.66 per service (average allowed $2.14).
Does Medicare cover J2916?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J2916 can be billed per day?
20 on outpatient hospital claims; 20 on practitioner claims (NCCI medically unlikely edits).
Related J29 codes
- J2910 — Injection, aurothioglucose, up to 50 mg
- J2919 — Injection, methylprednisolone sodium succinate, 5 mg
- J2920 — Injection, methylprednisolone sodium succinate, up to 40 mg
- J2930 — Injection, methylprednisolone sodium succinate, up to 125 mg
- J2940 — Injection, somatrem, 1 mg
- J2941 — Injection, somatropin, 1 mg
- J2950 — Injection, promazine hcl, up to 25 mg
- J2993 — Injection, reteplase, 18.1 mg
- J2995 — Injection, streptokinase, per 250,000 iu
- J2997 — Injection, alteplase recombinant, 1 mg
- J2998 — Injection, plasminogen, human-tvmh, 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 J2916
- Watch J2916 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2916
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.