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HCPCS code J2997: Alteplase injection, per 1 mg2026 Medicare rate & RVUs

Reports recombinant alteplase furnished for thrombolytic treatment or vascular-access device declotting, with each HCPCS unit representing 1 mg.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J2997

Alteplase injection, per 1 mg

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for J2997 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What J2997 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What J2997 covers

Alteplase is a recombinant clot-dissolving drug used intravenously for conditions such as acute ischemic stroke and pulmonary embolism. It may also be instilled into an occluded vascular access device to restore patency. Hospitals and other entities furnishing the drug may report this HCPCS drug code; a related procedure code, when applicable, identifies the service rather than the drug itself.

CMS assigns J2997 physician fee schedule status E, excluding it from the physician fee schedule. When Medicare covers the drug, it is a Part B drug generally priced using CMS quarterly Average Sales Price drug pricing files; special Medicare coverage instructions apply. One HCPCS unit represents 1 mg of alteplase. Report units according to the amount of drug represented by the billed units, and distinguish the drug from any separately reported procedure.

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 J2997 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

J2997 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

J2997 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
J2997 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the J2997 rate is calculated

Each of J2997’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 · J2997

RVUs × geographic indexes × conversion factor

Office or facility?

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 J2997

J2997 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 · J2997

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

J2997 isn’t priced in this setting.

J2997 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • J2997

    Alteplase injection, per 1 mg0 wRVU

    Not priced

  • J2993

    Reteplase injection, per 18.1 mg0 wRVU

    Not priced

  • J2998

    Plasminogen injection, per 1 mg0 wRVU

    Not priced

  • 36593

    Device declot, thrombolytic treatment0 wRVU

    $38.08

How to choose

J2993Reteplase injectionPer 18.1 mg
J2993 identifies reteplase, not alteplase. Use J2997 when the drug furnished is alteplase.
J2998Plasminogen injectionPer 1 mg
J2998 identifies plasminogen, not alteplase. Choose the code for the drug furnished.
36593Device declotThrombolytic treatment
CPT 36593 describes thrombolytic declotting of an implanted vascular access device or catheter; J2997 identifies the alteplase drug.

Codes related to J2997

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to J2997
CodeHow it relatesNational office range
Often billed with
36593Device declot, thrombolytic treatmentIdentifies thrombolytic declotting of an implanted vascular access device or catheter; J2997 identifies alteplase.$32.48–$54.30
Used instead
J2993Reteplase injection, per 18.1 mgIdentifies reteplase, a different thrombolytic drug used for some overlapping treatment indications.No office rate

J2997 billing questions

How many milligrams does one J2997 unit represent?

One unit represents 1 mg of recombinant alteplase. Calculate units from the amount of alteplase represented on the claim.

How is J2997 different from J2998?

J2997 identifies alteplase; J2998 identifies plasminogen. Select the code for the drug furnished.

When is J2997 used with a catheter declotting procedure?

For thrombolytic declotting of an implanted vascular access device or catheter, CPT 36593 identifies the procedure, while J2997 identifies the alteplase drug.

Does Medicare pay J2997 under the physician fee schedule?

No. CMS assigns status E, excluding J2997 from the physician fee schedule. When covered, it is a Part B drug generally priced through CMS quarterly ASP drug pricing files.

What Medicare coverage instructions apply to J2997?

Special Medicare coverage instructions apply to J2997.

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

Open CMS sourceHow we calculate rates

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