HCPCS J3111

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

Drugs Drug code Work RVU per service none (2023 fee schedule; adds 0 work RVUs)

970
86th percentile among 6,405 codes billed · 2023
$166M
99th percentile among 6,405 codes billed · 2023
21.0M
100th percentile among 6,405 codes billed · 2023
15,120
99th percentile among 6,405 codes billed · 2023
58,747
99th percentile among 6,405 codes billed · 2023
+54.0%
Medicare payment on the code vs 2022; billers +30.7% · 2023

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
Florida141$23,465,9792,975,48916,17058,170
California111$19,073,4082,416,75714,91058,781
Texas85$12,185,2121,545,16716,80038,894
Pennsylvania59$10,434,1741,321,04016,59044,940
Illinois32$9,818,2661,248,09118,00898,374
Arizona43$7,689,322981,44819,53066,087
Maryland32$6,152,977778,27817,43055,987
New York21$5,461,722689,85019,95094,920
Tennessee19$4,880,408617,71615,540105,966
Ohio19$4,684,723593,89115,540121,633
South Carolina36$4,659,790591,09412,39030,870
North Carolina34$4,618,335584,01113,96538,167
Colorado42$4,548,614574,3539,76633,306
Virginia22$4,185,001528,99219,74054,484
Georgia23$3,975,973506,84312,81055,723

Not listed: 21 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 2023.

Top metro areas

observed calculated calculated calculated calculated
Miami-Fort Lauderdale-West Palm Beach, FL48$10,147,5281,293,84022,890
New York-Newark-Jersey City, NY-NJ35$7,106,182896,80817,640
Los Angeles-Long Beach-Anaheim, CA44$6,124,254779,17214,911
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD36$5,947,578749,71512,499
Phoenix-Mesa-Chandler, AZ32$5,878,640751,07819,005
Chicago-Naperville-Elgin, IL-IN23$5,263,005672,27117,430
Washington-Arlington-Alexandria, DC-VA-MD-WV31$4,737,552598,92117,430
Tampa-St. Petersburg-Clearwater, FL32$4,644,022587,79012,495
Houston-Pasadena-The Woodlands, TX28$4,236,592538,45217,958
Dallas-Fort Worth-Arlington, TX14$2,113,484266,91013,755
North Port-Bradenton-Sarasota, FL16$1,957,052246,7229,870
Austin-Round Rock-San Marcos, TX15$1,931,852243,91517,850
San Antonio-New Braunfels, TX15$1,921,049243,41010,500
Charleston-North Charleston, SC11$1,873,584237,09012,180
Denver-Aurora-Centennial, CO23$1,771,855224,4919,240

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 17 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing J3111 nationally

Rheumatology accounts for 45% of payment for J3111 nationally in 2023, across 8 specialties on claims.

observed calculated calculated calculated calculated calculated
Rheumatology45747%$75,124,51245%9,530,94920,855
Nurse Practitioner20021%$37,550,50723%4,751,85723,759
Endocrinology879.0%$12,891,2977.8%1,634,64318,789
Internal Medicine545.6%$8,152,5184.9%1,033,48919,139
Physician Assistant464.7%$7,995,0904.8%1,018,54122,142
Family Practice282.9%$6,597,9054.0%835,88529,853
Hematology-Oncology282.9%$4,150,8402.5%525,73418,776
Orthopedic Surgery171.8%$3,066,4991.9%389,86922,933

Not listed: 18 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 2023.

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