HCPCS J2357

Injection, omalizumab, 5 mg (CMS descriptor)

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

503
80th percentile among 6,253 codes billed · 2021
$102M
98th percentile among 6,253 codes billed · 2021
3.5M
98th percentile among 6,253 codes billed · 2021
5,115
98th percentile among 6,253 codes billed · 2021
18,434
99th percentile among 6,253 codes billed · 2021
+3.2%
Medicare payment on the code vs 2020; billers -1.6% · 2021

Trend

Medicare payment on the code

$0$50M$100M2020: $99M paid20202021: $102M paid20212022: $104M paid20222023: $109M paid20232024: $113M paid2024$113M$0$50M$100M2020: $99M paid20202021: $102M paid20212022: $104M paid20222023: $109M paid20232024: $113M paid2024$113M$0$50M$100M2020: $99M paid20202021: $102M paid20212022: $104M paid20222023: $109M paid20232024: $113M paid2024$113M$0$50M$100M2020: $99M paid20202021: $102M paid20212022: $104M paid20222023: $109M paid20232024: $113M paid2024$113M

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

Billers

02505002020: 511 providers20202021: 503 providers20212022: 577 providers20222023: 581 providers20232024: 617 providers202461702505002020: 511 providers20202021: 503 providers20212022: 577 providers20222023: 581 providers20232024: 617 providers202461702505002020: 511 providers20202021: 503 providers20212022: 577 providers20222023: 581 providers20232024: 617 providers202461702505002020: 511 providers20202021: 503 providers20212022: 577 providers20222023: 581 providers20232024: 617 providers2024617

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
2024617$113,422,267+4%3,851,8014,78516,9800.00
2023581$109,266,994+5%3,663,7234,71017,2970.00
2022577$104,463,833+2%3,547,7084,39516,3260.00
2021503$102,312,137+3%3,461,2135,11518,4340.00
2020511$99,168,050first year in data3,385,9534,84518,8420.00

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
Florida60$12,992,716434,0446,11316,466
Texas40$9,774,195335,5075,37023,035
California42$8,932,377307,5035,86225,811
Virginia33$7,851,732263,1025,32511,532
Arizona19$7,180,861239,88712,88532,997
Tennessee39$5,640,321192,1353,72011,757
South Carolina20$4,796,619161,9706,98317,722
Pennsylvania21$4,281,734143,8666,22518,435
New York23$3,708,758125,9673,65415,124
Maryland15$3,103,973103,9615,25019,046
North Carolina17$2,734,56591,4714,20012,237
Kansas14$2,547,67484,7825,45310,894
Illinois16$2,336,11277,6114,2459,642
Wisconsin12$1,811,35961,2155,0939,389
Washington13$1,515,89650,8363,4807,383

Not listed: 23 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
Phoenix-Mesa-Chandler, AZ15$5,801,987193,95712,885
Richmond, VA25$4,219,118140,5354,980
New York-Newark-Jersey City, NY-NJ20$3,907,122132,2114,780
Miami-Fort Lauderdale-West Palm Beach, FL11$3,296,748109,7488,580
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD12$2,699,20490,6125,828
Dallas-Fort Worth-Arlington, TX14$2,575,90093,1044,515
Kansas City, MO-KS14$2,554,03785,5924,440
Los Angeles-Long Beach-Anaheim, CA11$2,256,74674,8844,095
Chicago-Naperville-Elgin, IL-IN15$2,224,86874,1304,350
Nashville-Davidson--Murfreesboro--Franklin, TN13$1,829,72862,3703,930
Knoxville, TN13$1,290,60044,1903,165

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 11 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 J2357 nationally

Allergy/ Immunology accounts for 51% of payment for J2357 nationally in 2021, across 6 specialties on claims.

observed calculated calculated calculated calculated calculated
Allergy/ Immunology25350%$51,698,06651%1,759,2946,954
Nurse Practitioner11222%$18,246,35518%615,3675,494
Pulmonary Disease458.9%$12,090,37712%404,5068,989
Internal Medicine234.6%$6,461,4396.3%217,0699,438
Hematology-Oncology183.6%$3,082,2133.0%102,9625,720
Infectious Disease122.4%$2,908,9522.8%98,0858,174

Not listed: 13 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 J2357 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