HCPCS J1745

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

Drugs Drug code Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

1,367
88th percentile among 6,326 codes billed · 2022
$161M
99th percentile among 6,326 codes billed · 2022
5.7M
99th percentile among 6,326 codes billed · 2022
2,920
98th percentile among 6,326 codes billed · 2022
11,392
98th percentile among 6,326 codes billed · 2022
-19.3%
Medicare payment on the code vs 2021; billers +0.1% · 2022

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 Carolina89$11,232,745399,0223,47011,050
Texas115$10,857,599387,6842,8907,370
Florida107$10,618,683371,6362,6309,025
Pennsylvania74$9,192,693325,3763,49311,704
California72$7,428,762270,6662,2659,408
New York56$6,937,045244,4882,90513,711
Virginia30$6,345,158223,9844,90823,509
Ohio36$5,869,813207,9974,56012,970
South Carolina43$5,714,833204,2933,40014,200
Illinois57$5,587,793198,9512,29012,684
Maryland47$5,554,018196,4433,1909,887
Colorado36$4,992,367177,0863,83812,615
Oklahoma19$4,979,169177,7794,92040,021
Washington48$4,968,956177,0272,9058,923
Tennessee36$4,875,400174,4563,04511,275

Not listed: 18 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 2022.

Top metro areas

observed calculated calculated calculated calculated
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD63$8,259,240293,4273,980
Chicago-Naperville-Elgin, IL-IN44$4,812,489170,8272,233
Minneapolis-St. Paul-Bloomington, MN-WI51$4,501,005160,0481,470
Charlotte-Concord-Gastonia, NC-SC30$3,957,593139,4674,055
Houston-Pasadena-The Woodlands, TX29$3,555,690125,2424,100
New York-Newark-Jersey City, NY-NJ32$3,439,395121,1412,965
Richmond, VA14$3,328,028117,5386,895
Phoenix-Mesa-Chandler, AZ33$3,015,255108,2731,986
Dallas-Fort Worth-Arlington, TX42$2,888,392101,8832,050
Kansas City, MO-KS24$2,880,334102,4433,915
Denver-Aurora-Centennial, CO23$2,812,806100,1954,200
Baltimore-Columbia-Towson, MD20$2,774,46998,2123,786
Washington-Arlington-Alexandria, DC-VA-MD-WV27$2,464,69986,9812,820
Seattle-Tacoma-Bellevue, WA27$2,458,70187,9043,110
Los Angeles-Long Beach-Anaheim, CA29$2,286,26689,3092,100

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 2022.

Specialties billing J1745 nationally

Rheumatology accounts for 75% of payment for J1745 nationally in 2022, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Rheumatology78257%$120,376,25275%4,277,4685,470
Gastroenterology26219%$12,792,8678.0%452,3081,726
Nurse Practitioner1349.8%$10,871,7786.8%389,9402,910
Internal Medicine674.9%$6,071,3803.8%215,2243,212
Hematology-Oncology342.5%$2,167,6391.3%76,3802,246
Physician Assistant241.8%$2,005,9181.2%71,7032,988
Infectious Disease161.2%$1,867,0061.2%67,5494,222
Family Practice181.3%$1,533,0500.95%56,0733,115

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 2022.

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