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 (2023 fee schedule; adds 0 work RVUs)

848
85th percentile among 6,405 codes billed · 2023
$215M
99th percentile among 6,405 codes billed · 2023
55.2M
100th percentile among 6,405 codes billed · 2023
48,400
100th percentile among 6,405 codes billed · 2023
170,240
100th percentile among 6,405 codes billed · 2023
-7.8%
Medicare payment on the code vs 2022; billers +4.0% · 2023

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
Florida116$35,107,5049,010,65552,000216,250
Texas91$24,799,8356,408,81456,000157,600
Pennsylvania66$14,761,7843,789,91438,606150,800
California42$13,667,3083,534,29165,800169,140
New Jersey62$13,611,9743,490,75142,300141,100
Virginia32$11,573,3132,969,10674,500248,560
Illinois41$9,965,8342,563,79450,800163,000
Kentucky26$7,489,6211,942,00046,400228,350
North Carolina36$6,438,5071,657,80137,400105,900
Tennessee23$6,051,7091,560,40050,400157,840
South Carolina21$5,846,0561,501,40159,200145,200
Maryland25$5,641,7931,456,00041,000176,720
Arizona20$4,932,2141,261,80136,100174,320
New York26$4,812,8711,230,84046,40077,650
Delaware11$4,144,8161,067,40098,800180,200

Not listed: 24 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ60$13,800,2643,538,16146,400
Chicago-Naperville-Elgin, IL-IN42$10,353,1612,662,59451,001
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD52$10,318,0872,649,01631,600
Houston-Pasadena-The Woodlands, TX30$9,588,6022,476,60384,200
Miami-Fort Lauderdale-West Palm Beach, FL37$8,061,5912,073,10541,400
Washington-Arlington-Alexandria, DC-VA-MD-WV18$6,397,9901,645,10672,601
Tampa-St. Petersburg-Clearwater, FL24$5,822,1051,500,41040,505
Dallas-Fort Worth-Arlington, TX22$5,023,5841,296,60447,302
Los Angeles-Long Beach-Anaheim, CA14$4,136,7281,088,67148,913
Baltimore-Columbia-Towson, MD17$4,101,2071,061,00044,800
Orlando-Kissimmee-Sanford, FL12$3,852,690990,44081,000
Phoenix-Mesa-Chandler, AZ15$3,851,909985,00040,400
Kansas City, MO-KS13$3,848,703987,44066,840
Louisville/Jefferson County, KY-IN11$2,717,572700,80045,600
San Antonio-New Braunfels, TX12$2,692,492693,00038,000

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 18 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing J0717 nationally

Rheumatology accounts for 90% of payment for J0717 nationally in 2023, across 4 specialties on claims.

observed calculated calculated calculated calculated calculated
Rheumatology71985%$192,818,81590%49,624,60469,019
Internal Medicine485.7%$10,365,3754.8%2,658,32655,382
Nurse Practitioner546.4%$7,396,0443.4%1,902,24535,227
Physician Assistant151.8%$1,828,3000.85%469,40031,293

Not listed: 8 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 2023.

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