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HCPCS J2270 · Level II · Part B drug

HCPCS J2270: Injection, morphine sulfate, up to 10 mg

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for J2270

Billing unit
10 MG
Morphine sulfate injection
ASP payment limit
$7.259
October 2026; -10.2% vs July 2026
Practitioner MUE
9
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J2270 is the Level II code for Injection, morphine sulfate, up to 10 mg, billed per 10 MG. The Medicare Part B ASP payment limit for October 2026 is $7.259 per billing unit, down 10.2% from July 2026. The practitioner MUE allows up to 9 units per date of service (MAI 3). Under OPPS it carries status indicator N. The 10 mg billing unit means doses are reported in multiples of ten milligrams, with any remainder rounded per contractor policy; mismatched units against the NDC quantity trigger MUE and NDC-unit edits. The ASP crosswalk maps 17 NDCs to it, sold as Morphine Sulfate by Pfizer Inc, Hikma Pharmaceuticals USA Inc., Civica, Inc.. No current Billing and Coding Article lists J2270, so coverage follows the FDA label, compendia and any applicable NCD.

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J2270 at $7.259 per 10 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $8.087 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J2270
QuarterPayment limitPerCoinsurance
October 2026$7.25910 MG20%
July 2026$8.08710 MG—
Source: CMS Medicare Part B Drug Payment Limit File. Commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 17 NDCs from 3 labelers to J2270. Report the NDC in the claim's drug segment and bill the number of J2270 units that equals the quantity administered divided by 10 MG; the last column gives units per full package.

NDCs that crosswalk to J2270
NDCDrug nameLabelerPackage sizeBilling units / package
00409-1134-03Morphine SulfatePfizer Inc20 × 1100
00409-1134-05Morphine SulfatePfizer Inc50 × 1250
00409-1890-01Morphine SulfatePfizer Inc1 × 102
00409-1890-23Morphine SulfatePfizer Inc1 × 102
00409-1891-01Morphine SulfatePfizer Inc1 × 104
00409-1891-23Morphine SulfatePfizer Inc1 × 104
00409-1892-01Morphine SulfatePfizer Inc1 × 108
00409-1893-01Morphine SulfatePfizer Inc1 × 1010
00409-1893-23Morphine SulfatePfizer Inc1 × 1010
00409-1896-20Morphine SulfatePfizer Inc20 × 1100
00409-2022-01Morphine SulfatePfizer Inc50 × 1250
00641-6125-25Morphine SulfateHikma Pharmaceuticals USA Inc.1 × 2510
00641-6126-25Morphine SulfateHikma Pharmaceuticals USA Inc.1 × 2520
00641-6127-25Morphine SulfateHikma Pharmaceuticals USA Inc.1 × 2525
00641-6191-10Morphine SulfateHikma Pharmaceuticals USA Inc.1 × 102
00641-6192-10Morphine SulfateHikma Pharmaceuticals USA Inc.1 × 104
72572-0440-25Morphine SulfateCivica, Inc.1 × 2510

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J2270. For practitioners the limit is 9 units per date of service with adjudication indicator 3, a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation that the quantity was medically reasonable.

MUE values for J2270 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services93 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital153 Date of Service Edit: ClinicalClinical: Data
DME supplier3203 Date of Service Edit: ClinicalClinical: Data

NCCI edits and add-on relationships

No active practitioner PTP pair lists J2270 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

J2270 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

No current Billing and Coding Article lists J2270 in its HCPCS table. Coverage then follows the drug's FDA label, compendia and any National Coverage Determination; check the Medicare Coverage Database before administering off-label.

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J2270 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J2270 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks J2270 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

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Frequently asked questions — HCPCS J2270

What does HCPCS code J2270 describe?

J2270 is defined by CMS as "Injection, morphine sulfate, up to 10 mg". Each billing unit represents 10 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J2270 in October 2026?

The ASP-based payment limit is $7.259 per 10 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $8.087.

How many units of J2270 can be billed per day?

The practitioner Medically Unlikely Edit is 9 units per date of service with adjudication indicator 3 (3 Date of Service Edit: Clinical). MAI 3 edits can be appealed with documentation that the units were medically reasonable. CMS cites "Clinical: Data" as the rationale.

Which NDCs map to J2270?

The October 2026 ASP crosswalk lists 17 NDCs from 3 labelers: Morphine Sulfate (Pfizer Inc); Morphine Sulfate (Hikma Pharmaceuticals USA Inc.); Morphine Sulfate (Civica, Inc.). For example NDC 00409-1134-03 is a 20 package equal to 100 billing units. The crosswalk's billing-units-per-package figure converts each package into J2270 units.

Does J2270 have NCCI bundling edits?

No active practitioner PTP pairs list J2270 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.