HCPCS code J2545: Inhaled pentamidine, per 300 mg2026 Medicare rate & RVUs in Oregon
Reports a 300 mg unit of noncompounded pentamidine inhalation solution, commonly used to prevent Pneumocystis pneumonia in immunocompromised patients.
CMS doesn’t publish an office rate for J2545 in Oregon.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What J2545 covers
J2545 identifies an FDA-approved, unit-dose pentamidine isethionate solution that is not compounded and is administered by inhalation through durable medical equipment. Aerosolized pentamidine is used to prevent Pneumocystis jirovecii pneumonia in people at increased risk, including some immunocompromised patients. The drug is delivered through a nebulizer; this code identifies the inhaled product, distinct from injectable pentamidine.
One HCPCS unit represents 300 mg of pentamidine isethionate. CMS excludes J2545 from the physician fee schedule under status E. When Medicare covers the item, payment is made under another method; CMS classifies it as a Part B drug, generally priced from quarterly Average Sales Price files when covered. Special Medicare coverage instructions apply to this code. The aerosol treatment service has its own code, 94642, which describes aerosol inhalation treatment with pentamidine.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where J2545 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | Unavailable | Unavailable |
| Rest of Oregon | Unavailable | Unavailable |
How the J2545 rate is calculated
Each of J2545’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · J2545
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for J2545
J2545 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · J2545
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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J2545 isn’t priced in this setting.
J2545 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- J2516Pentamidine injectionPer 1 mg
- J2516 is for injectable pentamidine isethionate. J2545 is for the noncompounded inhalation solution delivered through DME.
- 94642Pentamidine treatmentEach treatment
- 94642 describes aerosol inhalation treatment with pentamidine; J2545 identifies the 300 mg drug unit.
- 94640Inhalation treatmentAcute obstruction or sputum induction
- 94640 describes inhalation treatment such as treatment for acute airway obstruction. Pentamidine aerosol treatment is specifically described by 94642.
J2545 billing questions
When should J2545 be used instead of J2516?
Use J2545 for the noncompounded inhalation solution delivered through DME. J2516 identifies injectable pentamidine, so the route and product determine the choice.
How many units should be reported?
Each unit represents 300 mg. Report units based on the amount of the drug furnished.
What does CPT 94642 describe?
CPT 94642 describes aerosol inhalation treatment with pentamidine. J2545 identifies the inhalation drug product.
Does J2545 have a physician fee schedule payment amount?
CMS assigns status E, excluding J2545 from the physician fee schedule. When Medicare covers it, payment is under another method; as a Part B drug, it is generally priced using CMS quarterly ASP files.
Does Medicare cover every use of J2545?
CMS assigns special Medicare coverage instructions to J2545.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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