J0225 HCPCS code: Injection, vutrisiran, 1 mg
J0225 is the HCPCS Level II code for injection, vutrisiran, 1 mg. In 2024 Medicare paid an average of $3,760.27 per service for J0225 across 21,002 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 25 per day on DME suppliers. Medicare volume rose 21% from 2023 to 2024 (17,415 to 21,002 services). In 2024, about 274 clinicians billed Medicare for J0225 for 285 beneficiaries; New York, Texas, Florida accounted for 58% of services.
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 | 2023-01-01 |
| Last action effective | 2023-01-01 |
Who bills J0225 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 274 |
| Medicare beneficiaries | 285 |
| States with claims | 10 |
| Share of services in top 3 states (New York, Texas, Florida) | 58% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0225, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 17,415 | 236 | $4,694.96 | $3,740.54 |
| 2024 | 21,002 | 285 | $4,719.96 | $3,760.27 |
States with the most J0225 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 4,046 | $3,462.24 |
| Texas | 2,450 | $3,867.89 |
| Florida | 2,069 | $3,869.04 |
| Maryland | 1,212 | $3,836.05 |
| California | 1,055 | $3,855.32 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 25 | Prescribing Information |
| outpatient hospital claims | 25 | Prescribing Information |
| practitioner claims | 25 | Prescribing Information |
What changed for J0225
- 2023-01-01: J0225 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 J0225?
J0225 is the HCPCS Level II code for injection, vutrisiran, 1 mg. Short descriptor: "Inj, vutrisiran, 1 mg".
How much does Medicare pay for J0225?
In 2024, the average Medicare payment was $3,760.27 per service (average allowed $4,719.96).
Does Medicare cover J0225?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0225 can be billed per day?
25 on DME suppliers; 25 on outpatient hospital claims; 25 on practitioner claims (NCCI medically unlikely edits).
Related J02 codes
- J0200 — Injection, alatrofloxacin mesylate, 100 mg
- J0202 — Injection, alemtuzumab, 1 mg
- J0205 — Injection, alglucerase, per 10 units
- J0206 — Injection, allopurinol sodium, 1 mg
- J0207 — Injection, amifostine, 500 mg
- J0208 — Injection, sodium thiosulfate (pedmark), 100 mg
- J0209 — Injection, sodium thiosulfate (hope), 100 mg
- J0210 — Injection, methyldopate hcl, up to 250 mg
- J0211 — Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (nithiodote)
- J0215 — Injection, alefacept, 0.5 mg
- J0216 — Injection, alfentanil hydrochloride, 500 micrograms
- J0217 — Injection, velmanase alfa-tycv, 1 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 J0225
- Watch J0225 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0225
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.