HCPCS J1745

Injection, infliximab, excludes biosimilar, 10 mg (CMS descriptor)

Drugs Drug code Work RVU per service none (2020 fee schedule; adds 0 work RVUs)

1,424
88th percentile among 6,116 codes billed · 2020
$255M
99th percentile among 6,116 codes billed · 2020
6.2M
99th percentile among 6,116 codes billed · 2020
3,130
98th percentile among 6,116 codes billed · 2020
11,921
98th percentile among 6,116 codes billed · 2020

Trend

Medicare payment on the code

$0$100M$200M2020: $255M paid20202021: $199M paid20212022: $161M paid20222023: $145M paid20232024: $137M paid2024$137M$0$100M$200M2020: $255M paid20202021: $199M paid20212022: $161M paid20222023: $145M paid20232024: $137M paid2024$137M$0$100M$200M2020: $255M paid20202021: $199M paid20212022: $161M paid20222023: $145M paid20232024: $137M paid2024$137M$0$100M$200M2020: $255M paid20202021: $199M paid20212022: $161M paid20222023: $145M paid20232024: $137M paid2024$137M

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

Billers

01,0002020: 1,424 providers20202021: 1,366 providers20212022: 1,367 providers20222023: 1,352 providers20232024: 1,377 providers20241,37701,0002020: 1,424 providers20202021: 1,366 providers20212022: 1,367 providers20222023: 1,352 providers20232024: 1,377 providers20241,37701,0002020: 1,424 providers20202021: 1,366 providers20212022: 1,367 providers20222023: 1,352 providers20232024: 1,377 providers20241,37701,0002020: 1,424 providers20202021: 1,366 providers20212022: 1,367 providers20222023: 1,352 providers20232024: 1,377 providers20241,377

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
20241,377$137,038,110-5%5,576,8572,78011,3090.00
20231,352$144,851,522-10%5,598,2592,92611,2980.00
20221,367$160,694,628-19%5,713,7032,92011,3920.00
20211,366$199,165,988-22%6,041,6803,13011,8130.00
20201,424$254,958,889first year in data6,192,9933,13011,9210.00

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
Florida125$18,490,770445,3913,0009,424
North Carolina89$17,822,273431,3733,68013,796
Texas87$16,172,339394,5444,0308,863
Pennsylvania77$13,947,185335,5103,13110,999
California77$13,581,137333,4022,57012,092
New York61$10,406,357252,1693,24612,752
South Carolina56$9,659,429237,4632,87513,263
Virginia35$9,196,441222,8253,24020,525
Minnesota81$8,856,612212,8151,43010,090
Maryland46$8,335,383203,3333,4059,758
Missouri42$8,328,633202,1953,80513,482
Illinois59$8,104,253197,1932,34011,616
Ohio37$8,048,212194,6024,66011,964
Tennessee33$7,366,227180,3944,12010,878
Washington36$6,773,906164,0693,99112,195

Not listed: 17 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
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD69$12,195,392294,9613,400
Minneapolis-St. Paul-Bloomington, MN-WI78$8,613,099207,0051,465
Chicago-Naperville-Elgin, IL-IN40$6,271,065152,7192,278
New York-Newark-Jersey City, NY-NJ41$6,225,144149,8262,580
Charlotte-Concord-Gastonia, NC-SC25$6,189,274150,3336,573
Houston-Pasadena-The Woodlands, TX24$5,242,724127,3474,590
Richmond, VA12$4,948,804119,3767,379
Denver-Aurora-Centennial, CO23$4,271,586104,1553,800
Dallas-Fort Worth-Arlington, TX25$4,224,547101,3043,510
Kansas City, MO-KS21$4,207,055101,3273,910
Baltimore-Columbia-Towson, MD19$4,138,479101,5234,170
Phoenix-Mesa-Chandler, AZ22$3,966,49197,3443,210
Los Angeles-Long Beach-Anaheim, CA27$3,958,157100,8272,115
St. Louis, MO-IL20$3,780,96092,6263,600
Miami-Fort Lauderdale-West Palm Beach, FL24$3,508,90684,3073,250

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 35 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 J1745 nationally

Rheumatology accounts for 77% of payment for J1745 nationally in 2020, across 9 specialties on claims.

observed calculated calculated calculated calculated calculated
Rheumatology85660%$195,758,69977%4,753,4755,553
Gastroenterology26519%$18,914,0287.4%458,1941,729
Nurse Practitioner866.0%$13,344,4585.2%323,8823,766
Internal Medicine684.8%$9,655,4443.8%233,2513,430
Hematology-Oncology503.5%$4,847,4811.9%118,5722,371
Physician Assistant211.5%$2,844,4371.1%69,1303,292
Infectious Disease201.4%$2,469,8530.97%61,6483,082
Family Practice140.98%$2,179,5880.85%53,4633,819
Allergy/ Immunology120.84%$1,315,3410.52%32,2832,690

Not listed: 11 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 J1745 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