Home › Drug Codes › J Codes › J2760 · PHENTOLAMINE MESYLATE

Updated July 1st, 2026

PHENTOLAMINE MESYLATE J Code: J2760

Injection, phentolamine mesylate, up to 5 mg

Medicare Payment Limit ?

$288.625

/ HCPCS billing unit · Q3 2026

APC Payment Limit ?

$288.625

/ HCPCS billing unit · APC 1458

ASP ?

$•••.••

WAC · AWP ?

$•••.••

NDCs Crosswalked ?

View NDC crosswalk →

Self-Administered Drug Exclusion Wellpoint Federal lists J2760 as usually self-administered and excludes it from Part B coverage in its jurisdiction. Check the article for your MAC before billing: Wellpoint Federal · All SAD lists →

Drug & Product Overview

HCPCS Descriptor Injection, phentolamine mesylate, up to 5 mg

HCPCS Added Date January 1, 1982

Manufacturer Multiple Manufacturers

Route of Administration Intramuscular, Intravenous

Generic Status Multi-Source; Generic

Dosage Form Injection | Injection, Powder, For Solution

About PHENTOLAMINE MESYLATE

Phentolamine Mesylate is a medication aligned to the HCPCS J Code: J2760 for billing, pricing, and reimbursement purposes in the United States. This Cardiology medication is administered via the intramuscular or intravenous routes and manufactured by multiple companies.

According to CMS Drug Use Information: Drug uses not available

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. Showing 2 of 3 NDCs — log in for the full crosswalk.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
00143-9564-01	Phentolamine Mesylate	Hikma Pharmaceuticals USA Inc.	1	5 MG / 1 ML
00143-9564-10	Phentolamine Mesylate	Hikma Pharmaceuticals USA Inc.	10	5 MG / 1 ML
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Login to view 1 more NDC package View pricing, complete NDC-to-HCPCS alignments, and package details.

PHENTOLAMINE MESYLATE Pricing & Reimbursement

J2760 Private Payer Reimbursement

$427.74 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

PHENTOLAMINE MESYLATE CPT Administration Codes

CPT Code	Description
96372	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular
96374	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug), IV push, single, or initial substance/drug

Not on the CMS JW / JZ list

CMS does not include Phentolamine Mesylate (J2760) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J2760. Wastage billing guide →

PHENTOLAMINE MESYLATE Medically Unlikely Edits (MUE)

The most billing units of J2760 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 5 mg.

Practitioner Office & Hospital Outpatient

2 units / day

= 10 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

PHENTOLAMINE MESYLATE Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Dermal necrosis and sloughing following IV administration or extravasation of norepinephrine Dermal necrosis and sloughing following norepinephrine extravasation Diagnosis of pheochromocytoma Diagnosis of pheochromocytoma (phentolamine blocking test) Hypertensive episodes in pheochromocytoma

Drug Class

Adrenergic alpha-Antagonists [MoA]alpha-Adrenergic Blocker [EPC]

Frequently Asked Questions

Is there an available Phentolamine Mesylate billing and coding guide?

We have not yet identified a manufacturer source of Phentolamine Mesylate billing and coding information.

Are there any available Phentolamine Mesylate patient assistance programs?

Our team did not identify a source for Phentolamine Mesylate patient assistance information. Please reach out to our team if you feel that this is a mistake.

Where can I find Phentolamine Mesylate prescribing information?

Our team is still working to identify a prescribing information source for PHENTOLAMINE MESYLATE

Where can I find Phentolamine Mesylate side effect information?

Our team has not yet identified a source of side effects information for PHENTOLAMINE MESYLATE. Please check back in a few weeks.

Does billing PHENTOLAMINE MESYLATE require JZ/JW wastage modifiers?

CMS does not include PHENTOLAMINE MESYLATE (J2760) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J2760. For more information, visit the link below.

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PHENTOLAMINE MESYLATE Pricing

Q3 2026

J2760

Medicare Payment Limit per HCPCS unit

$288.625

Medicare Co-Insurance20% · per HCPCS unit $57.73

APC Payment Limit per HCPCS unit

$288.625

ASP · WAC · AWP per HCPCS unit and NDC package

NDC Crosswalk

3 NDCs

00143-9564-01 · 00143-9564-10 · +1 more View full NDC crosswalk →

For manufacturers

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