J8522 HCPCS code: Capecitabine, oral, 50 mg
J8522 is the HCPCS Level II code for capecitabine, oral, 50 mg. In 2024 Medicare paid an average of $0.05 per service for J8522 across 71,237 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 150 per day on DME suppliers. In 2024, 11 suppliers billed Medicare for J8522 (purchases), serving 71 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 | O1D — Chemotherapy |
| Added | 2024-10-01 |
| Last action effective | 2025-01-01 |
Who bills J8522 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 11 |
| Referring clinicians | 59 |
| Medicare beneficiaries | 71 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J8522, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 71,237 | 71 | $0.06 | $0.05 |
States with the most J8522 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 43,169 | $0.05 |
| Pennsylvania | 22,518 | $0.05 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 150 | Prescribing Information |
What changed for J8522
- 2024-10-01: J8522 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 J8522?
J8522 is the HCPCS Level II code for capecitabine, oral, 50 mg. Short descriptor: "Capecitabine, oral, 50 mg".
How much does Medicare pay for J8522?
In 2024, the average Medicare payment was $0.05 per service (average allowed $0.06).
Does Medicare cover J8522?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J8522 can be billed per day?
150 on DME suppliers (NCCI medically unlikely edits).
Related J85 codes
- J8501 — Aprepitant, oral, 5 mg
- J8510 — Busulfan; oral, 2 mg
- J8515 — Cabergoline, oral, 0.25 mg
- J8520 — Capecitabine, oral, 150 mg
- J8521 — Capecitabine, oral, 500 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 J8522
- Watch J8522 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J8522
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.