J7315 HCPCS code: Mitomycin, ophthalmic, 0.2 mg
J7315 is the HCPCS Level II code for mitomycin, ophthalmic, 0.2 mg. In 2024 Medicare paid an average of $137.99 per service for J7315 across 22 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 2 per day on outpatient hospital claims. Medicare volume rose 5% from 2022 to 2024 (21 to 22 services). In 2024, about 10 clinicians billed Medicare for J7315 for 19 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2013-01-01 |
| Last action effective | 2016-01-01 |
Who bills J7315 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 10 |
| Medicare beneficiaries | 19 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7315, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 21 | 16 | $203.81 | $162.74 |
| 2023 | 17 | 14 | $265.27 | $211.35 |
| 2024 | 22 | 19 | $195.01 | $137.99 |
States with the most J7315 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 18 | $149.96 |
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 J7315
- 2013-01-01: J7315 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 J7315?
J7315 is the HCPCS Level II code for mitomycin, ophthalmic, 0.2 mg. Short descriptor: "Ophthalmic mitomycin".
How much does Medicare pay for J7315?
In 2024, the average Medicare payment was $137.99 per service (average allowed $195.01).
Does Medicare cover J7315?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J7315 can be billed per day?
2 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related J73 codes
- J7300 — Intrauterine copper contraceptive (paragard)
- J7301 — Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg
- J7302 — Levonorgestrel-releasing intrauterine contraceptive system, 52 mg
- J7303 — Contraceptive supply, hormone containing vaginal ring, each
- J7304 — Contraceptive supply, hormone containing patch, each
- J7306 — Levonorgestrel (contraceptive) implant system, including implants and supplies
- J7307 — Etonogestrel (contraceptive) implant system, including implant and supplies
- J7308 — Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)
- J7309 — Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram
- J7310 — Ganciclovir, 4.5 mg, long-acting implant
- J7311 — Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg
- J7312 — Injection, dexamethasone, intravitreal implant, 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 J7315
- Watch J7315 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7315
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.