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Drugs codes by Medicare payment, 2023

Every code billed to Original Medicare Part B, with how many providers bill it and what it paid.

Codes billed
471
of 6,405 codes · 2023
Medicare payment on the code
$14.1B
15% of all code payment · 2023
Services
944.4M
36% of all services on codes · 2023
Largest code
J0178
$2.35B paid, 17% of category payment · 2023
Change from prior year
+26.1%
Medicare payment on the code vs 2022 · 2023

Top 200 drugs codes

The 200 with the most payment of 296 codes.

Not listed: 175 codes billed by fewer than 11 providers (small cells; each has its own page with the count).

observed calculated calculated calculated calculated calculated
J0178Injection, aflibercept, 1 mg3,204$2,354,722,37217%3,427,458722
J9271Injection, pembrolizumab, 1 mg1,841$1,154,350,1978.2%27,083,04512,400
J2777Injection, faricimab-svoa, 0.1 mg2,039$967,501,7516.9%33,468,9799,900
J0897Injection, denosumab, 1 mg10,057$875,043,2536.2%48,034,8932,640
Q4262Dual layer impax membrane, per square centimeter141$834,254,0905.9%900,9531,358
91322Descriptor not shown (CPT code)29,357$492,127,1733.5%3,490,45468
90677Descriptor not shown (CPT code)52,451$436,258,3443.1%1,572,26321
J0129Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)1,221$429,252,2623.0%12,857,9508,125
91320Descriptor not shown (CPT code)27,083$422,068,6493.0%3,323,18360
90662Descriptor not shown (CPT code)70,752$394,299,7302.8%5,611,11342
90694Descriptor not shown (CPT code)51,679$365,021,2622.6%4,923,38450
J2778Injection, ranibizumab, 0.1 mg1,208$281,806,7832.0%1,556,832649
J9144Injection, daratumumab, 10 mg and hyaluronidase-fihj615$229,940,9341.6%6,102,7278,100
Q4236Carepatch, per square centimeter79$223,639,0471.6%229,1821,650
J0717Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)848$214,619,1401.5%55,220,40248,400
J9299Injection, nivolumab, 1 mg505$211,141,0981.5%9,040,66114,740
J0585Injection, onabotulinumtoxina, 1 unit3,636$210,564,2881.5%43,501,0807,486
J1602Injection, golimumab, 1 mg, for intravenous use1,041$196,573,5281.4%18,901,78813,251
J3111Injection, romosozumab-aqqg, 1 mg970$165,655,9721.2%21,005,98015,120
J1745Injection, infliximab, excludes biosimilar, 10 mg1,352$144,851,5221.0%5,598,2592,926
J3262Injection, tocilizumab, 1 mg618$140,982,1981.00%30,446,77639,364
Q4217Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter65$136,855,1760.97%133,9591,380
Q4253Zenith amniotic membrane, per square centimeter73$133,000,4390.94%207,5951,516
Q4205Membrane graft or membrane wrap, per square centimeter63$123,911,8610.88%107,872970
J3380Injection, vedolizumab, intravenous, 1 mg620$119,595,3100.85%6,978,4118,100
J3245Injection, tildrakizumab, 1 mg225$112,576,2920.80%1,028,0163,800
J2357Injection, omalizumab, 5 mg581$109,266,9940.77%3,663,7234,710
J1569Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg542$98,127,6560.70%2,757,6873,524
Q5128Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg373$95,848,1930.68%442,174675
J2785Injection, regadenoson, 0.1 mg6,388$92,688,8730.66%2,186,558208
J9217Leuprolide acetate (for depot suspension), 7.5 mg3,683$76,777,2490.54%577,092123
J2350Injection, ocrelizumab, 1 mg105$76,752,4100.54%1,767,15112,600
J9312Injection, rituximab, 10 mg317$74,353,2840.53%1,198,2273,100
Q4281Barrera sl or barrera dl, per square centimeter33$62,374,6310.44%51,1811,184
J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg381$58,169,2620.41%1,764,4293,040
J1306Injection, inclisiran, 1 mg462$57,100,5880.40%6,096,5168,094
J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg180$53,562,0910.38%1,410,7093,615
Q4188Amnioarmor, per square centimeter47$49,849,3220.35%66,963966
J2781Injection, pegcetacoplan, intravitreal, 1 mg490$49,839,0960.35%415,159555
J0881Injection, darbepoetin alfa, 1 microgram (non-esrd use)1,114$46,394,5920.33%19,791,12812,175
J1439Injection, ferric carboxymaltose, 1 mg1,209$40,672,6060.29%46,709,06927,750
J0517Injection, benralizumab, 1 mg200$39,638,3280.28%304,1231,230
J7327Hyaluronan or derivative, monovisc, for intra-articular injection, per dose1,365$37,304,9780.26%67,43932
J2182Injection, mepolizumab, 1 mg187$36,905,7110.26%1,607,6297,100
J3304Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg1,181$36,230,0140.26%2,759,2331,472
J1437Injection, ferric derisomaltose, 10 mg581$35,315,8800.25%2,143,5532,600
J1556Injection, immune globulin (bivigam), 500 mg46$35,204,3200.25%627,0026,350
J7326Hyaluronan or derivative, gel-one, for intra-articular injection, per dose1,610$34,994,9490.25%87,01535
Q4194Novachor, per square centimeter69$32,854,1410.23%40,756384
Q4186Epifix, per square centimeter122$26,992,8940.19%229,031675

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Descriptions of HCPCS Level II codes are the official CMS descriptors, shown verbatim; CPT codes show a ClaimLight category in place of the descriptor. Data year 2023.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed