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 (2020 fee schedule; adds 0 work RVUs)

662
82nd percentile among 6,116 codes billed · 2020
$267M
99th percentile among 6,116 codes billed · 2020
41.4M
100th percentile among 6,116 codes billed · 2020
46,400
100th percentile among 6,116 codes billed · 2020
179,890
100th percentile among 6,116 codes billed · 2020

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
Florida95$44,018,9246,812,92748,400201,920
Texas66$30,102,2104,720,93058,000190,200
Pennsylvania50$17,124,6082,652,00145,000105,240
New Jersey39$15,778,9852,454,84246,000186,360
California44$15,545,0972,426,47147,000125,390
Virginia37$15,539,9242,412,80147,800154,000
Illinois28$10,183,3871,576,41949,000112,210
Kentucky13$9,112,8841,414,00079,600264,320
Tennessee17$8,441,7631,310,80069,200164,880
Maryland21$7,578,6881,184,20046,400162,800
North Carolina27$7,224,7141,136,40034,800104,020
Arizona18$6,456,114999,40430,900149,700
South Carolina16$6,053,377941,00039,600142,450
New York22$5,775,414892,80036,90073,770
Arkansas11$5,413,880838,00167,200176,400

Not listed: 26 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ44$16,450,5022,549,64242,400
Houston-Pasadena-The Woodlands, TX25$13,038,0212,050,20158,800
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD33$11,889,6891,846,80031,000
Miami-Fort Lauderdale-West Palm Beach, FL34$11,031,6971,710,02239,700
Chicago-Naperville-Elgin, IL-IN30$10,782,9581,669,21949,000
Washington-Arlington-Alexandria, DC-VA-MD-WV19$7,725,4291,195,80038,600
Tampa-St. Petersburg-Clearwater, FL15$6,920,0411,068,80052,400
Baltimore-Columbia-Towson, MD12$5,755,672902,20063,800
Dallas-Fort Worth-Arlington, TX14$5,389,075838,80749,204
Phoenix-Mesa-Chandler, AZ13$5,186,485802,80334,400
Kansas City, MO-KS14$4,880,535754,40040,400
Los Angeles-Long Beach-Anaheim, CA14$4,840,538765,26234,214
Virginia Beach-Chesapeake-Norfolk, VA-NC13$4,175,583647,80140,400
Charlotte-Concord-Gastonia, NC-SC12$1,824,613283,00026,400
Des Moines-West Des Moines, IA11$1,806,085279,40017,600

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 15 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing J0717 nationally

Rheumatology accounts for 90% of payment for J0717 nationally in 2020, across 4 specialties on claims.

observed calculated calculated calculated calculated calculated
Rheumatology59289%$240,865,90990%37,445,19663,252
Internal Medicine274.1%$11,314,0144.2%1,749,71364,804
Nurse Practitioner182.7%$8,790,6563.3%1,356,80275,378
Physician Assistant111.7%$2,318,6070.87%358,00132,546

Not listed: 9 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 2020.

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