J0137 HCPCS code: Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg
J0137 is the HCPCS Level II code for injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg. In 2024 Medicare paid an average of $0.03 per service for J0137 across 1,200 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 400 per day on outpatient hospital claims. In 2024, about 2 clinicians billed Medicare for J0137 for 12 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2023-07-01 |
| Last action effective | 2024-07-01 |
Who bills J0137 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2 |
| Medicare beneficiaries | 12 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0137, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 1,200 | 12 | $0.05 | $0.03 |
States with the most J0137 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Virginia | 1,100 | $0.03 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 400 | Prescribing Information |
| practitioner claims | 400 | Prescribing Information |
What changed for J0137
- 2023-07-01: J0137 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 J0137?
J0137 is the HCPCS Level II code for injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg. Short descriptor: "Inj, acetaminophen (hikma)".
How much does Medicare pay for J0137?
In 2024, the average Medicare payment was $0.03 per service (average allowed $0.05).
Does Medicare cover J0137?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0137 can be billed per day?
400 on outpatient hospital claims; 400 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)
- J0130 — Injection abciximab, 10 mg
- 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
- J0138 — Injection, acetaminophen 10 mg and ibuprofen 3 mg
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J0137
- Watch J0137 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0137
Sources: CMS HCPCS Level II release October 2026; 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.