J2919 HCPCS code: Injection, methylprednisolone sodium succinate, 5 mg
J2919 is the HCPCS Level II code for injection, methylprednisolone sodium succinate, 5 mg. In 2024 Medicare paid an average of $0.22 per service for J2919 across 4,178,201 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 5400 per day on DME suppliers. In 2024, 20 suppliers billed Medicare for J2919 (purchases), serving 36 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 | 2024-04-01 |
| Last action effective | 2025-01-01 |
Who bills J2919 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 20 |
| Referring clinicians | 28 |
| Medicare beneficiaries | 36 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2919, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 4,178,201 | 93,851 | $0.28 | $0.22 |
States with the most J2919 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 580,090 | $0.22 |
| Illinois | 393,207 | $0.23 |
| Texas | 375,728 | $0.22 |
| California | 263,185 | $0.22 |
| New York | 198,595 | $0.22 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 5400 | Prescribing Information |
| outpatient hospital claims | 5400 | Prescribing Information |
| practitioner claims | 5400 | Prescribing Information |
Medicare policy articles for this code
- A57114: Billing and Coding: Trigger Point Injections (First Coast Service Options, Inc. (MAC - Part B))
- A57751: Billing and Coding: Trigger Point Injections (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
Covered diagnoses (2 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| M79.12 | Myalgia of auxiliary muscles, head and neck | 2 |
| M79.18 | Myalgia, other site | 2 |
What changed for J2919
- 2024-04-01: J2919 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 J2919?
J2919 is the HCPCS Level II code for injection, methylprednisolone sodium succinate, 5 mg. Short descriptor: "Inj, methylpred sod succ 5mg".
How much does Medicare pay for J2919?
In 2024, the average Medicare payment was $0.22 per service (average allowed $0.28).
Does Medicare cover J2919?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J2919?
Medicare policy articles that cite J2919 list 2 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include M79.12 (Myalgia of auxiliary muscles, head and neck), M79.18 (Myalgia, other site). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J2919 can be billed per day?
5400 on DME suppliers; 5400 on outpatient hospital claims; 5400 on practitioner claims (NCCI medically unlikely edits).
Related J29 codes
- J2910 — Injection, aurothioglucose, up to 50 mg
- J2916 — Injection, sodium ferric gluconate complex in sucrose injection, 12.5 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
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Next steps
- Run a reimbursement report for a device billed under J2919
- Watch J2919 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2919
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.