J2997 HCPCS code: Injection, alteplase recombinant, 1 mg
J2997 is the HCPCS Level II code for injection, alteplase recombinant, 1 mg. In 2024 Medicare paid an average of $68.89 per service for J2997 across 36,415 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 100 per day on outpatient hospital claims. Medicare volume fell 13% from 2022 to 2024 (42,029 to 36,415 services). In 2024, about 3,586 clinicians billed Medicare for J2997 for 10,982 beneficiaries; California, Texas, Florida accounted for 34% 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 | 2001-01-01 |
| Last action effective | 2001-01-01 |
Who bills J2997 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 3,586 |
| Medicare beneficiaries | 10,982 |
| States with claims | 48 |
| Share of services in top 3 states (California, Texas, Florida) | 34% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2997, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 42,029 | 12,166 | $85.51 | $67.48 |
| 2023 | 43,631 | 12,614 | $86.20 | $68.01 |
| 2024 | 36,415 | 10,982 | $87.57 | $68.89 |
States with the most J2997 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 5,856 | $69.58 |
| Texas | 3,492 | $69.24 |
| Florida | 2,958 | $69.43 |
| Illinois | 1,982 | $69.42 |
| Arizona | 1,717 | $68.44 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 100 | Prescribing Information |
| practitioner claims | 100 | Prescribing Information |
What changed for J2997
- 2001-01-01: J2997 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 J2997?
J2997 is the HCPCS Level II code for injection, alteplase recombinant, 1 mg. Short descriptor: "Alteplase recombinant".
How much does Medicare pay for J2997?
In 2024, the average Medicare payment was $68.89 per service (average allowed $87.57).
Does Medicare cover J2997?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J2997 can be billed per day?
100 on outpatient hospital claims; 100 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
- 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
- J2998 — Injection, plasminogen, human-tvmh, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J2997
- Watch J2997 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2997
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.