J0172 HCPCS code: Injection, aducanumab-avwa, 2 mg
J0172 is the HCPCS Level II code for injection, aducanumab-avwa, 2 mg. CMS terminated J0172 on 2025-12-31; do not bill it for later dates of service. In 2024 Medicare paid an average of $1.89 per service for J0172 across 25,680 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. Medicare volume fell 67% from 2022 to 2024 (77,604 to 25,680 services). In 2024, about 18 clinicians billed Medicare for J0172 for 15 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 00 — Not separately priced by Medicare |
| BETOS category | O1E — Other drugs |
| Added | 2022-01-01 |
| Last action effective | 2026-01-01 |
| Terminated | 2025-12-31 |
Who bills J0172 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 18 |
| Medicare beneficiaries | 15 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0172, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 77,604 | 152 | $5.85 | $4.64 |
| 2023 | 28,261 | 35 | $2.45 | $1.95 |
| 2024 | 25,680 | 15 | $2.37 | $1.89 |
What changed for J0172
- 2022-01-01: J0172 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 J0172?
J0172 is the HCPCS Level II code for injection, aducanumab-avwa, 2 mg. Short descriptor: "Inj, aducanumab-avwa, 2 mg".
How much does Medicare pay for J0172?
In 2024, the average Medicare payment was $1.89 per service (average allowed $2.37).
Does Medicare cover J0172?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
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
- J0137 — Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 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 J0172
- Watch J0172 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0172
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.