HCPCS J3111

Injection, romosozumab-aqqg, 1 mg (CMS descriptor)

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

499
80th percentile among 6,253 codes billed · 2021
$68M
97th percentile among 6,253 codes billed · 2021
9.3M
99th percentile among 6,253 codes billed · 2021
13,966
99th percentile among 6,253 codes billed · 2021
44,394
99th percentile among 6,253 codes billed · 2021
+86.1%
Medicare payment on the code vs 2020; billers +74.5% · 2021

Trend

Medicare payment on the code

$0$100M$200M2020: $37M paid20202021: $68M paid20212022: $108M paid20222023: $166M paid20232024: $241M paid2024$241M$0$100M$200M2020: $37M paid20202021: $68M paid20212022: $108M paid20222023: $166M paid20232024: $241M paid2024$241M$0$100M$200M2020: $37M paid20202021: $68M paid20212022: $108M paid20222023: $166M paid20232024: $241M paid2024$241M$0$100M$200M2020: $37M paid20202021: $68M paid20212022: $108M paid20222023: $166M paid20232024: $241M paid2024$241M

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

Billers

05001,0002020: 286 providers20202021: 499 providers20212022: 742 providers20222023: 970 providers20232024: 1,339 providers20241,33905001,0002020: 286 providers20202021: 499 providers20212022: 742 providers20222023: 970 providers20232024: 1,339 providers20241,33905001,0002020: 286 providers20202021: 499 providers20212022: 742 providers20222023: 970 providers20232024: 1,339 providers20241,33905001,0002020: 286 providers20202021: 499 providers20212022: 742 providers20222023: 970 providers20232024: 1,339 providers20241,339

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
20241,339$241,453,680+46%28,416,63414,49060,7110.00
2023970$165,655,972+54%21,005,98015,12058,7470.00
2022742$107,565,003+58%14,408,67913,86053,7410.00
2021499$68,077,807+86%9,337,61413,96644,3940.00
2020286$36,589,755first year in data5,119,67512,86347,1980.00

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
Florida90$12,094,8871,661,94714,07046,872
California42$5,585,270763,34014,59644,719
Texas55$5,397,911743,51613,23024,381
Illinois19$5,342,071725,65615,64590,636
Pennsylvania18$3,689,201504,21420,68549,886
South Carolina19$3,279,048449,72415,12051,576
Maryland22$2,947,062405,50111,86568,617
Virginia18$2,440,806338,31315,85638,619
Arizona17$2,357,218323,05615,13132,386
New York14$2,213,405303,24015,33047,334
Colorado20$2,167,176295,7888,71536,530
North Carolina20$1,959,977268,38110,08033,548
Iowa16$1,404,966194,0409,24032,288

Not listed: 30 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
Miami-Fort Lauderdale-West Palm Beach, FL33$4,508,167625,69917,010
New York-Newark-Jersey City, NY-NJ21$2,896,594396,27016,590
Tampa-St. Petersburg-Clearwater, FL18$2,803,807383,25013,650
Chicago-Naperville-Elgin, IL-IN15$2,508,667340,62015,960
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD11$2,387,419326,55419,110
Phoenix-Mesa-Chandler, AZ16$2,264,386310,45618,066
Houston-Pasadena-The Woodlands, TX20$1,965,538270,49012,495
Washington-Arlington-Alexandria, DC-VA-MD-WV20$1,930,369267,0188,715
Los Angeles-Long Beach-Anaheim, CA13$1,541,527211,56814,490
Dallas-Fort Worth-Arlington, TX16$1,331,243182,0707,560
Charlotte-Concord-Gastonia, NC-SC12$1,080,550148,0509,765

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 J3111 nationally

Rheumatology accounts for 51% of payment for J3111 nationally in 2021, across 7 specialties on claims.

observed calculated calculated calculated calculated calculated
Rheumatology26052%$34,394,92251%4,720,89418,157
Nurse Practitioner8717%$13,062,55719%1,792,25020,601
Physician Assistant367.2%$5,095,2797.5%697,78719,383
Endocrinology367.2%$4,080,3546.0%557,04615,474
Internal Medicine336.6%$3,761,2565.5%512,06315,517
Orthopedic Surgery112.2%$1,926,3002.8%263,13123,921
Family Practice112.2%$1,662,6932.4%228,69120,790

Not listed: 12 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 J3111 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