HCPCS J0897

Injection, denosumab, 1 mg (CMS descriptor)

Drugs Drug code Work RVU per service none (2021 fee schedule; adds 0 work RVUs)

9,981
97th percentile among 6,253 codes billed · 2021
$763M
100th percentile among 6,253 codes billed · 2021
47.0M
100th percentile among 6,253 codes billed · 2021
2,640
98th percentile among 6,253 codes billed · 2021
15,512
98th percentile among 6,253 codes billed · 2021
+9.6%
Medicare payment on the code vs 2020; billers +3.2% · 2021

Trend

Medicare payment on the code

$0$500M$1.00B2020: $696M paid20202021: $763M paid20212022: $805M paid20222023: $875M paid20232024: $979M paid2024$979M$0$500M$1.00B2020: $696M paid20202021: $763M paid20212022: $805M paid20222023: $875M paid20232024: $979M paid2024$979M$0$500M$1.00B2020: $696M paid20202021: $763M paid20212022: $805M paid20222023: $875M paid20232024: $979M paid2024$979M$0$500M$1.00B2020: $696M paid20202021: $763M paid20212022: $805M paid20222023: $875M paid20232024: $979M paid2024$979M

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

Billers

05,00010K2020: 9,672 providers20202021: 9,981 providers20212022: 10K providers20222023: 10K providers20232024: 9,797 providers20249,79705,00010K2020: 9,672 providers20202021: 9,981 providers20212022: 10K providers20222023: 10K providers20232024: 9,797 providers20249,79705,00010K2020: 9,672 providers20202021: 9,981 providers20212022: 10K providers20222023: 10K providers20232024: 9,797 providers20249,79705,00010K2020: 9,672 providers20202021: 9,981 providers20212022: 10K providers20222023: 10K providers20232024: 9,797 providers20249,797

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
20249,797$978,864,123+12%48,156,7162,76015,3660.00
202310,057$875,043,253+9%48,034,8932,64015,4800.00
202210,191$804,559,510+5%47,552,6052,64015,1800.00
20219,981$763,317,410+10%46,983,0782,64015,5120.00
20209,672$696,220,853first year in data45,291,4702,64015,4800.00

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
Florida1,116$102,754,4346,283,2363,12018,270
California961$79,714,6984,935,5272,82016,080
Texas594$41,390,0602,545,5992,52013,167
Pennsylvania521$38,678,1002,383,7922,40013,860
New York461$33,517,5142,068,9692,82013,020
Illinois419$33,036,6302,014,2832,70013,566
Maryland306$29,914,8361,854,4273,30119,950
Virginia338$28,658,1761,777,4763,09015,439
New Jersey352$28,047,2651,726,4303,12015,096
Arizona252$24,409,6481,493,2673,27021,307
North Carolina437$23,912,4041,472,3012,1609,732
Georgia285$23,096,8451,428,5392,52017,568
South Carolina245$19,653,6951,215,1562,52017,676
Indiana264$19,371,0901,195,6382,58014,622
Tennessee263$18,863,5331,163,1652,40013,932

Not listed: 1 billers with an armed-forces or unknown state code (XX); they are in the national totals.

Not listed: 3 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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ576$44,509,0142,749,1262,880
Los Angeles-Long Beach-Anaheim, CA339$24,644,7021,542,4632,702
Chicago-Naperville-Elgin, IL-IN317$24,113,6441,467,6862,580
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD263$22,751,5661,393,0633,120
Washington-Arlington-Alexandria, DC-VA-MD-WV222$20,703,5881,297,0503,600
Miami-Fort Lauderdale-West Palm Beach, FL172$20,569,0581,266,2224,020
Phoenix-Mesa-Chandler, AZ159$15,229,961931,8343,120
Tampa-St. Petersburg-Clearwater, FL134$12,512,433762,2593,810
Dallas-Fort Worth-Arlington, TX192$12,442,614763,9162,340
Baltimore-Columbia-Towson, MD133$11,489,399706,6512,700
North Port-Bradenton-Sarasota, FL92$10,650,439652,9844,200
San Francisco-Oakland-Fremont, CA133$10,639,548661,3533,300
Virginia Beach-Chesapeake-Norfolk, VA-NC103$10,440,959642,3833,360
Atlanta-Sandy Springs-Roswell, GA144$8,755,889547,4242,413
Orlando-Kissimmee-Sanford, FL91$8,526,932521,4362,940

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 98 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing J0897 nationally

Hematology-Oncology accounts for 29% of payment for J0897 nationally in 2021, across 22 specialties on claims.

observed calculated calculated calculated calculated calculated
Hematology-Oncology1,80318%$219,711,81129%13,486,0867,480
Rheumatology1,75618%$172,532,22823%10,611,0386,043
Internal Medicine1,68317%$73,216,8479.6%4,541,7452,699
Medical Oncology5375.4%$60,256,9947.9%3,696,1626,883
Endocrinology9329.3%$57,777,5247.6%3,559,3993,819
Nurse Practitioner7577.6%$49,317,0806.5%3,031,7764,005
Family Practice1,19912%$39,685,6575.2%2,467,7292,058
Urology3563.6%$27,099,6123.6%1,657,3784,656
Physician Assistant3213.2%$22,140,6362.9%1,360,4184,238
Obstetrics & Gynecology2502.5%$11,224,8361.5%698,4762,794
Hematology490.49%$5,983,4580.78%363,6527,421
Infectious Disease570.57%$5,697,1880.75%352,2026,179
Orthopedic Surgery580.58%$4,245,1160.56%263,2714,539
Neurology130.13%$2,159,0920.28%133,62010,278
General Practice220.22%$1,596,1090.21%98,9074,496

Not listed: 22 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 2021.

Top billers of J0897 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