J8560 HCPCS code: Etoposide; oral, 50 mg
J8560 is the HCPCS Level II code for etoposide; oral, 50 mg. In 2024 Medicare paid an average of $59.64 per service for J8560 across 15,825 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 6 per day on outpatient hospital claims. Medicare volume fell 19% from 2022 to 2024 (19,631 to 15,825 services). In 2024, 155 suppliers billed Medicare for J8560 (purchases), serving 339 beneficiaries; California, New York, Florida accounted for 32% 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 | 1995-01-01 |
Who bills J8560 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 155 |
| Referring clinicians | 343 |
| Medicare beneficiaries | 339 |
| States with claims | 27 |
| Share of services in top 3 states (California, New York, Florida) | 32% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 191 | 392 |
| 2023 | 201 | 400 |
| 2024 | 155 | 339 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J8560, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 19,631 | 392 | $75.62 | $59.27 |
| 2023 | 22,103 | 400 | $76.61 | $59.67 |
| 2024 | 15,825 | 339 | $76.27 | $59.64 |
States with the most J8560 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 1,964 | $59.68 |
| New York | 1,727 | $59.89 |
| Florida | 1,092 | $59.89 |
| Wisconsin | 1,025 | $58.38 |
| Iowa | 873 | $59.79 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 6 | Prescribing Information |
What changed for J8560
- 1995-01-01: J8560 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 J8560?
J8560 is the HCPCS Level II code for etoposide; oral, 50 mg. Short descriptor: "Etoposide oral 50 mg".
How much does Medicare pay for J8560?
In 2024, the average Medicare payment was $59.64 per service (average allowed $76.27).
Does Medicare cover J8560?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J8560 can be billed per day?
6 on outpatient hospital claims (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
- J8522 — Capecitabine, oral, 50 mg
- J8530 — Cyclophosphamide; oral, 25 mg
- J8540 — Dexamethasone, oral, 0.25 mg
- J8541 — Dexamethasone (hemady), oral, 0.25 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 J8560
- Watch J8560 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J8560
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.