J8520 HCPCS code: Capecitabine, oral, 150 mg
J8520 is the HCPCS Level II code for capecitabine, oral, 150 mg. CMS terminated J8520 on 2024-09-30; do not bill it for later dates of service. In 2024 Medicare paid an average of $0.07 per service for J8520 across 1,400,028 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. Medicare volume rose 119% from 2022 to 2024 (638,309 to 1,400,028 services). In 2024, 496 suppliers billed Medicare for J8520 (purchases), serving 2,633 beneficiaries; California, New York, Pennsylvania accounted for 25% 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 | O1D — Chemotherapy |
| Added | 2000-01-01 |
| Last action effective | 2024-10-01 |
| Terminated | 2024-09-30 |
Who bills J8520 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 496 |
| Referring clinicians | 2,025 |
| Medicare beneficiaries | 2,633 |
| States with claims | 47 |
| Share of services in top 3 states (California, New York, Pennsylvania) | 25% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 599 | 3,438 |
| 2023 | 579 | 3,490 |
| 2024 | 496 | 2,633 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J8520, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 638,309 | 3,438 | $0.45 | $0.35 |
| 2023 | 669,774 | 3,490 | $0.52 | $0.39 |
| 2024 | 1,400,028 | 2,633 | $0.10 | $0.07 |
States with the most J8520 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 160,077 | $0.08 |
| New York | 94,197 | $0.07 |
| Pennsylvania | 88,503 | $0.07 |
| Florida | 71,571 | $0.07 |
| Illinois | 66,930 | $0.07 |
What changed for J8520
- 2000-01-01: J8520 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 J8520?
J8520 is the HCPCS Level II code for capecitabine, oral, 150 mg. Short descriptor: "Capecitabine, oral, 150 mg".
How much does Medicare pay for J8520?
In 2024, the average Medicare payment was $0.07 per service (average allowed $0.10).
Does Medicare cover J8520?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Related J85 codes
- J8501 — Aprepitant, oral, 5 mg
- J8510 — Busulfan; oral, 2 mg
- J8515 — Cabergoline, oral, 0.25 mg
- J8521 — Capecitabine, oral, 500 mg
- J8522 — Capecitabine, oral, 50 mg
- J8530 — Cyclophosphamide; oral, 25 mg
- J8540 — Dexamethasone, oral, 0.25 mg
- J8541 — Dexamethasone (hemady), oral, 0.25 mg
- J8560 — Etoposide; oral, 50 mg
- J8562 — Fludarabine phosphate, oral, 10 mg
- J8565 — Gefitinib, oral, 250 mg
- J8597 — Antiemetic drug, oral, not otherwise specified
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 J8520
- Watch J8520 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J8520
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.