HCPCS J0717

Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) (CMS descriptor)

Drugs Drug code Work RVU per service none (2024 fee schedule; adds 0 work RVUs)

958
86th percentile among 6,471 codes billed · 2024
$220M
99th percentile among 6,471 codes billed · 2024
61.2M
100th percentile among 6,471 codes billed · 2024
45,600
100th percentile among 6,471 codes billed · 2024
196,400
100th percentile among 6,471 codes billed · 2024
+2.6%
Medicare payment on the code vs 2023; billers +13.0% · 2024

Trend

Medicare payment on the code

$0$100M$200M2020: $267M paid20202021: $272M paid20212022: $233M paid20222023: $215M paid20232024: $220M paid2024$220M$0$100M$200M2020: $267M paid20202021: $272M paid20212022: $233M paid20222023: $215M paid20232024: $220M paid2024$220M$0$100M$200M2020: $267M paid20202021: $272M paid20212022: $233M paid20222023: $215M paid20232024: $220M paid2024$220M$0$100M$200M2020: $267M paid20202021: $272M paid20212022: $233M paid20222023: $215M paid20232024: $220M paid2024$220M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

05001,0002020: 662 providers20202021: 751 providers20212022: 815 providers20222023: 848 providers20232024: 958 providers202495805001,0002020: 662 providers20202021: 751 providers20212022: 815 providers20222023: 848 providers20232024: 958 providers202495805001,0002020: 662 providers20202021: 751 providers20212022: 815 providers20222023: 848 providers20232024: 958 providers202495805001,0002020: 662 providers20202021: 751 providers20212022: 815 providers20222023: 848 providers20232024: 958 providers2024958

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
2024958$220,117,291+3%61,165,04545,600196,4000.00
2023848$214,619,140-8%55,220,40248,400170,2400.00
2022815$232,670,295-14%51,914,53148,000168,0000.00
2021751$271,682,287+2%47,180,23248,400172,7000.00
2020662$266,528,248first year in data41,410,51946,400179,8900.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
Florida136$36,817,50310,204,13344,900224,405
Texas102$24,432,0486,807,41853,400156,320
California54$14,851,2224,156,55258,827189,653
Pennsylvania78$14,732,0394,081,55339,605125,520
New Jersey69$13,474,2063,741,27139,400133,441
Virginia34$10,423,5982,889,40070,600246,930
Illinois38$10,033,3062,782,33861,121169,010
Kentucky31$7,571,7322,116,80044,400248,900
North Carolina47$6,903,2621,920,80533,20093,920
South Carolina21$6,226,9761,729,40051,200204,400
Maryland25$5,717,5751,590,60041,200191,120
Tennessee22$5,396,7961,500,95651,200193,180
Arizona23$4,916,8211,358,40137,200202,180
New York24$4,578,7071,265,24048,70083,980
Georgia17$3,852,6361,072,46340,800219,120

Not listed: 22 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ61$12,988,4823,597,40750,000
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD60$10,641,4992,955,70535,807
Chicago-Naperville-Elgin, IL-IN38$9,993,4932,771,13861,121
Houston-Pasadena-The Woodlands, TX36$9,664,4632,696,80058,800
Miami-Fort Lauderdale-West Palm Beach, FL36$7,156,3331,996,01742,400
Washington-Arlington-Alexandria, DC-VA-MD-WV14$6,046,5381,681,80085,000
Tampa-St. Petersburg-Clearwater, FL27$5,753,6571,595,66043,200
Dallas-Fort Worth-Arlington, TX23$4,771,7171,322,40650,800
Baltimore-Columbia-Towson, MD21$4,644,2961,291,60048,400
Los Angeles-Long Beach-Anaheim, CA19$4,530,8821,294,52544,800
Kansas City, MO-KS16$3,951,6131,094,80060,200
Orlando-Kissimmee-Sanford, FL14$3,891,6591,085,20268,700
Phoenix-Mesa-Chandler, AZ16$3,612,074995,40142,700
Louisville/Jefferson County, KY-IN12$3,284,660913,20044,800
North Port-Bradenton-Sarasota, FL16$2,703,854746,20137,300

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 21 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.

Specialties billing J0717 nationally

Rheumatology accounts for 88% of payment for J0717 nationally in 2024, across 4 specialties on claims.

observed calculated calculated calculated calculated calculated
Rheumatology78282%$194,548,61788%54,064,81569,137
Internal Medicine495.1%$10,482,2204.8%2,912,68159,442
Nurse Practitioner767.9%$8,907,6254.0%2,473,86632,551
Physician Assistant303.1%$2,815,4411.3%782,26026,075

Not listed: 10 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2024.

Top billers of J0717 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations