Skip to main content
HCPCS J2274 · Level II · Part B drug

HCPCS J2274: Injection, morphine sulfate, preservative-free for epidural or intrathecal use,

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 J2274

Billing unit
10 MG
Inj morphine pf epid ithc
ASP payment limit
$16.044
October 2026; -15.2% vs July 2026
Practitioner MUE
250
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
1
7 states

TL;DR

HCPCS J2274 is the Level II code for Injection, morphine sulfate, preservative-free for epidural or intrathecal use,, billed per 10 MG. The Medicare Part B ASP payment limit for October 2026 is $16.044 per billing unit, down 15.2% from July 2026. The practitioner MUE allows up to 250 units per date of service (MAI 3). Under OPPS it carries status indicator N. Site-specific administration routes in the descriptor tie the drug to a particular procedure code; the pairing is where NCCI column-1/column-2 edits and modifier decisions arise. The ASP crosswalk maps 8 NDCs to it, sold as Morphine Sulfate, Duramorph, Infumorph 200 by Pfizer Inc, Hikma Pharmaceuticals USA Inc., Piramal Critical Care Inc. 1 Medicare coverage article lists the code across 7 states, including .

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J2274 at $16.044 per 10 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $18.914 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J2274
QuarterPayment limitPerCoinsurance
October 2026$16.04410 MG20%
July 2026$18.91410 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 8 NDCs from 3 labelers to J2274. Report the NDC in the claim's drug segment and bill the number of J2274 units that equals the quantity administered divided by 10 MG; the last column gives units per full package.

NDCs that crosswalk to J2274
NDCDrug nameLabelerPackage sizeBilling units / package
00409-3814-12Morphine SulfatePfizer Inc10 × 53
00409-3815-12Morphine SulfatePfizer Inc10 × 55
00641-6019-10DuramorphHikma Pharmaceuticals USA Inc.10 × 1010
00641-6020-10DuramorphHikma Pharmaceuticals USA Inc.10 × 105
00641-6039-01Infumorph 200Hikma Pharmaceuticals USA Inc.20 × 120
00641-6040-01Infumorph 500Hikma Pharmaceuticals USA Inc.20 × 150
66794-0160-02MitigoPiramal Critical Care Inc20 × 120
66794-0162-02MitigoPiramal Critical Care Inc20 × 150

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J2274. For practitioners the limit is 250 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 J2274 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services2503 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital1003 Date of Service Edit: ClinicalClinical: Data
DME supplier03 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J2274 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.

J2274 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

1 current Medicare Administrative Contractor article lists J2274 in their HCPCS tables, covering 7 states. Each article carries the covered and non-covered ICD-10 codes that medical-necessity denials (CARC 50) are adjudicated against.

Billing and Coding Articles listing J2274
ArticleTitleContractor(s)StatesRelated LCD
Billing and Coding: Implantable Infusion PumpPalmetto GBAAL GA NC SC TN VA WVL33461

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J2274 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J2274 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 J2274 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.

Explore QuickCodeExplore QuickRCMBook a demo

Frequently asked questions — HCPCS J2274

What does HCPCS code J2274 describe?

J2274 is defined by CMS as "Injection, morphine sulfate, preservative-free for epidural or intrathecal use,". 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 J2274 in October 2026?

The ASP-based payment limit is $16.044 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 $18.914.

How many units of J2274 can be billed per day?

The practitioner Medically Unlikely Edit is 250 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 J2274?

The October 2026 ASP crosswalk lists 8 NDCs from 3 labelers: Morphine Sulfate (Pfizer Inc); Duramorph (Hikma Pharmaceuticals USA Inc.); Infumorph 200 (Hikma Pharmaceuticals USA Inc.); Infumorph 500 (Hikma Pharmaceuticals USA Inc.). For example NDC 00409-3814-12 is a 10 package equal to 3 billing units. The crosswalk's billing-units-per-package figure converts each package into J2274 units.

Does J2274 have NCCI bundling edits?

No active practitioner PTP pairs list J2274 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Which Medicare coverage articles mention J2274?

1 current Billing and Coding Article in the Medicare Coverage Database list J2274, covering 7 states: (Billing and Coding: Implantable Infusion Pump).

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.