Summary & Overview
HCPCS Level II J2704: Injection, Propofol 10 mg
HCPCS Level II code J2704 denotes an injection of propofol in 10 mg units, used to report the drug component of intravenous sedation and general anesthesia. Nationally, accurate reporting of drug HCPCS codes like J2704 matters for procedure costing, anesthesia billing, and pharmacy utilization tracking across hospital and ambulatory surgical settings. This code is most relevant where propofol is administered for induction or maintenance of anesthesia and for monitored sedation during procedures.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for propofol administration, typical sites of service, and how J2704 is used in billing lines. The publication summarizes common modifier considerations and payer patterns where available, presents benchmark insights and pricing context when present, and outlines policy and coding guidance that can affect coverage and claims processing.
The content is intended for a national audience of coding professionals, anesthesia providers, billing staff, and policy analysts seeking a concise reference for HCPCS Level II code J2704 and its role in peri-procedural drug reporting.
Billing Code Overview
HCPCS Level II code J2704 describes Injection, propofol, 10 mg. This code represents a medication administration line item for the sedative-hypnotic agent propofol measured in 10 mg units.
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Service type: Medication administration / intravenous anesthetic
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Typical site of service: Procedures performed in settings where intravenous sedation or general anesthesia is delivered, such as hospital operating rooms, ambulatory surgical centers, procedural suites, and monitored procedural areas.
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Clinical & Coding Specifications
Clinical Context
A 45-year-old female is scheduled for a brief outpatient endoscopic procedure (diagnostic upper endoscopy) in an ambulatory surgery center. The anesthesia team administers intravenous propofol for procedural sedation to achieve rapid onset of sedation and quick recovery. The clinical workflow: pre-procedure evaluation and informed consent by the proceduralist and anesthesia or sedation-trained clinician; establishment of IV access; baseline monitoring including ECG, pulse oximetry, blood pressure, and capnography as indicated; incremental bolus or infusion dosing of propofol with continuous monitoring; procedure performed by the gastroenterologist while the sedation clinician manages airway and hemodynamics; post-procedure recovery until discharge criteria are met. Typical site of service: ambulatory surgery center or hospital outpatient department. Service type: intravenous sedative/anesthetic agent administered for monitored anesthesia care or deep sedation for a short diagnostic or therapeutic procedure.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral Procedure | When identical procedures are performed on both sides and facility requires modifier for injectable-related encounter billing. |