J0180 HCPCS code: Injection, agalsidase beta, 1 mg
J0180 is the HCPCS Level II code for injection, agalsidase beta, 1 mg. In 2024 Medicare paid an average of $161.41 per service for J0180 across 86,294 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 140 per day on outpatient hospital claims. Medicare volume rose 35% from 2022 to 2024 (63,999 to 86,294 services). In 2024, about 142 clinicians billed Medicare for J0180 for 68 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 | 2005-01-01 |
| Last action effective | 2005-01-01 |
Who bills J0180 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 142 |
| Medicare beneficiaries | 68 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0180, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 63,999 | 62 | $191.75 | $153.19 |
| 2023 | 70,104 | 66 | $197.24 | $157.11 |
| 2024 | 86,294 | 68 | $202.64 | $161.41 |
States with the most J0180 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 12,625 | $171.77 |
| California | 7,647 | $172.93 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 140 | Clinical: Data |
| practitioner claims | 140 | Clinical: Data |
What changed for J0180
- 2005-01-01: J0180 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 J0180?
J0180 is the HCPCS Level II code for injection, agalsidase beta, 1 mg. Short descriptor: "Agalsidase beta injection".
How much does Medicare pay for J0180?
In 2024, the average Medicare payment was $161.41 per service (average allowed $202.64).
Does Medicare cover J0180?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0180 can be billed per day?
140 on outpatient hospital claims; 140 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
- J0137 — Injection, acetaminophen (hikma), not therapeutically equivalent to j0131, 10 mg
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Next steps
- Run a reimbursement report for a device billed under J0180
- Watch J0180 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0180
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.