J0130 HCPCS code: Injection abciximab, 10 mg
J0130 is the HCPCS Level II code for injection abciximab, 10 mg. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 6 per day on outpatient hospital claims.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 1999-01-01 |
| Last action effective | 2018-01-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 6 | Prescribing Information |
| practitioner claims | 4 | Clinical: Data |
What changed for J0130
- 1999-01-01: J0130 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J0130?
J0130 is the HCPCS Level II code for injection abciximab, 10 mg. Short descriptor: "Abciximab injection".
Does Medicare cover J0130?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J0130 can be billed per day?
6 on outpatient hospital claims; 4 on practitioner claims (NCCI medically unlikely edits).
Related J01 codes
- J0120 — Injection, tetracycline, up to 250 mg
- J0121 — Injection, omadacycline, 1 mg
- J0122 — Injection, eravacycline, 1 mg
- J0129 — Injection, 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)
- J0131 — Injection, acetaminophen, not otherwise specified,10 mg
- J0132 — Injection, acetylcysteine, 100 mg
- J0133 — Injection, acyclovir, 5 mg
- J0134 — Injection, acetaminophen (fresenius kabi), not therapeutically equivalent to j0131, 10 mg
- J0135 — Injection, adalimumab, 20 mg
- J0136 — Injection, acetaminophen (b braun), not therapeutically equivalent to j0131, 10 mg
- J0137 — Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg
- J0138 — Injection, acetaminophen 10 mg and ibuprofen 3 mg
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Next steps
- Run a reimbursement report for a device billed under J0130
- Watch J0130 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0130
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.