J0457 HCPCS code: Injection, aztreonam, 100 mg
J0457 is the HCPCS Level II code for injection, aztreonam, 100 mg. In 2024 Medicare paid an average of $1.79 per service for J0457 across 21,296 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 80 per day on outpatient hospital claims. Medicare volume rose 384% from 2023 to 2024 (4,404 to 21,296 services). In 2024, about 40 clinicians billed Medicare for J0457 for 65 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 | 2024-01-01 |
Who bills J0457 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 40 |
| Medicare beneficiaries | 65 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0457, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 4,404 | 20 | $3.10 | $2.47 |
| 2024 | 21,296 | 65 | $2.25 | $1.79 |
States with the most J0457 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 10,242 | $1.75 |
| Florida | 3,286 | $1.80 |
| New York | 110 | $1.76 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 80 | Prescribing Information |
| practitioner claims | 80 | Prescribing Information |
What changed for J0457
- 2023-07-01: J0457 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 J0457?
J0457 is the HCPCS Level II code for injection, aztreonam, 100 mg. Short descriptor: "Injection, aztreonam, 100 mg".
How much does Medicare pay for J0457?
In 2024, the average Medicare payment was $1.79 per service (average allowed $2.25).
Does Medicare cover J0457?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0457 can be billed per day?
80 on outpatient hospital claims; 80 on practitioner claims (NCCI medically unlikely edits).
Related J04 codes
- J0400 — Injection, aripiprazole, intramuscular, 0.25 mg
- J0401 — Injection, aripiprazole (abilify maintena), 1 mg
- J0402 — Injection, aripiprazole (abilify asimtufii), 1 mg
- J0456 — Injection, azithromycin, 500 mg
- J0458 — Injection, aztreonam/avibactam, 7.5 mg/2.5 mg (10 mg)
- J0461 — Injection, atropine sulfate, 0.01 mg
- J0462 — Injection, atropine sulfate, not therapeutically equivalent to j0461, 0.01 mg
- J0463 — Injection, atropine sulfate (fresenius and therapeutically equivalent), 0.01 mg
- J0470 — Injection, dimercaprol, per 100 mg
- J0475 — Injection, baclofen, 10 mg
- J0476 — Injection, baclofen, 50 mcg for intrathecal trial
- J0480 — Injection, basiliximab, 20 mg
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Next steps
- Run a reimbursement report for a device billed under J0457
- Watch J0457 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0457
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.