HCPCS J1745

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

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

1,366
88th percentile among 6,253 codes billed · 2021
$199M
99th percentile among 6,253 codes billed · 2021
6.0M
99th percentile among 6,253 codes billed · 2021
3,130
98th percentile among 6,253 codes billed · 2021
11,813
98th percentile among 6,253 codes billed · 2021
-21.9%
Medicare payment on the code vs 2020; billers -4.1% · 2021

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
North Carolina88$13,748,536415,4163,37011,959
Florida112$13,175,065395,5552,5638,636
Texas100$12,813,195389,3723,3498,405
Pennsylvania66$10,974,181330,2563,91511,311
California71$9,646,450296,2022,75110,570
New York58$8,629,917261,0923,33713,307
South Carolina50$7,705,645237,2093,01513,402
Virginia29$7,647,127231,3475,45024,924
Maryland48$6,918,445210,7353,49510,471
Illinois58$6,791,519205,8932,82010,208
Ohio34$6,675,158201,9144,88012,359
Colorado40$6,095,456184,7213,58011,644
Washington47$6,052,938183,1042,8069,883
Missouri34$6,045,782183,1254,17014,314
Minnesota62$5,975,493180,8821,5559,128

Not listed: 16 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
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD62$10,007,957302,1653,923
Minneapolis-St. Paul-Bloomington, MN-WI58$5,760,227174,4221,590
Chicago-Naperville-Elgin, IL-IN44$5,606,600170,0952,765
Charlotte-Concord-Gastonia, NC-SC27$4,737,004143,2055,160
New York-Newark-Jersey City, NY-NJ36$4,267,171128,1722,633
Denver-Aurora-Centennial, CO27$4,156,973126,5414,380
Houston-Pasadena-The Woodlands, TX28$4,139,467124,8714,020
Richmond, VA12$4,021,973121,1557,972
Phoenix-Mesa-Chandler, AZ33$3,569,021108,4141,990
Baltimore-Columbia-Towson, MD21$3,520,806107,1093,844
Kansas City, MO-KS23$3,444,243103,9924,410
Dallas-Fort Worth-Arlington, TX31$3,275,93798,5732,524
Los Angeles-Long Beach-Anaheim, CA27$3,114,57499,4172,720
Seattle-Tacoma-Bellevue, WA26$2,954,56789,7512,925
St. Louis, MO-IL17$2,820,38585,7943,650

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 32 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 J1745 nationally

Rheumatology accounts for 76% of payment for J1745 nationally in 2021, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Rheumatology81059%$151,130,77676%4,581,5385,656
Gastroenterology24818%$14,337,2457.2%433,3971,748
Nurse Practitioner1118.1%$12,134,1826.1%368,7613,322
Internal Medicine594.3%$7,649,2623.8%230,5853,908
Hematology-Oncology423.1%$3,250,5651.6%98,0172,334
Infectious Disease231.7%$2,719,2491.4%84,0313,654
Physician Assistant231.7%$2,272,0981.1%70,2683,055
Family Practice181.3%$1,857,8130.93%58,3483,242

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 2021.

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