J0216 — Injection, alfentanil hydrochloride, 500 micrograms
J0216 is a HCPCS Level II code for injection, alfentanil hydrochloride, 500 micrograms. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
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The CMS record for J0216
- Long descriptor
- Injection, alfentanil hydrochloride, 500 micrograms
- Short descriptor
- Inj, alfentanil hcl, 500mcg
- Added
- July 1, 2023
- BETOS
- O1E
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to J0216
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J0216 is not quite right, the correct code is very often within a few positions of it.
- J0205Injection, alglucerase, per 10 unitsterminated
- J0206Injection, allopurinol sodium, 1 mg
- J0207Injection, amifostine, 500 mg
- J0208Injection, sodium thiosulfate (pedmark), 100 mg
- J0209Injection, sodium thiosulfate (hope), 100 mg
- J0210Injection, methyldopate hcl, up to 250 mg
- J0211Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)
- J0215Injection, alefacept, 0.5 mgterminated
- J0217Injection, velmanase alfa-tycv, 1 mg
- J0218Injection, olipudase alfa-rpcp, 1 mg
- J0219Injection, avalglucosidase alfa-ngpt, 4 mg
- J0220Injection, alglucosidase alfa, 10 mg, not otherwise specified
- J0221Injection, alglucosidase alfa, (lumizyme), 10 mg
- J0222Injection, patisiran, 0.1 mg
- J0223Injection, givosiran, 0.5 mg
- J0224Injection, lumasiran, 0.5 mg
Questions about J0216
What is HCPCS code J0216?
J0216 is a HCPCS Level II code for injection, alfentanil hydrochloride, 500 micrograms. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J0216?
The CMS HCPCS file marks J0216 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is J0216 paid under the physician fee schedule?
J0216 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).