J0517 HCPCS code: Injection, benralizumab, 1 mg
J0517 is the HCPCS Level II code for injection, benralizumab, 1 mg. In 2024 Medicare paid an average of $128.99 per service for J0517 across 917,659 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 30 per day on outpatient hospital claims. Medicare volume rose 20% from 2022 to 2024 (763,249 to 917,659 services). In 2024, about 2,898 clinicians billed Medicare for J0517 for 6,427 beneficiaries; Florida, Texas, Tennessee accounted for 28% 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 | 2019-01-01 |
| Last action effective | 2019-01-01 |
Who bills J0517 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,898 |
| Medicare beneficiaries | 6,427 |
| States with claims | 41 |
| Share of services in top 3 states (Florida, Texas, Tennessee) | 28% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0517, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 763,249 | 5,575 | $163.85 | $130.49 |
| 2023 | 844,821 | 6,100 | $163.62 | $130.10 |
| 2024 | 917,659 | 6,427 | $162.30 | $128.99 |
States with the most J0517 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 107,756 | $130.29 |
| Texas | 87,571 | $128.07 |
| Tennessee | 64,386 | $129.65 |
| California | 62,374 | $126.80 |
| Pennsylvania | 50,303 | $130.32 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 30 | Prescribing Information |
| practitioner claims | 30 | Prescribing Information |
What changed for J0517
- 2019-01-01: J0517 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 J0517?
J0517 is the HCPCS Level II code for injection, benralizumab, 1 mg. Short descriptor: "Inj., benralizumab, 1 mg".
How much does Medicare pay for J0517?
In 2024, the average Medicare payment was $128.99 per service (average allowed $162.30).
Does Medicare cover J0517?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0517 can be billed per day?
30 on outpatient hospital claims; 30 on practitioner claims (NCCI medically unlikely edits).
Related J05 codes
- J0500 — Injection, dicyclomine hcl, up to 20 mg
- J0515 — Injection, benztropine mesylate, per 1 mg
- J0520 — Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg
- J0525 — Injection, cefotetan disodium, 10 mg
- J0528 — Injection, fosfomycin disodium, 20 mg
- J0558 — Injection, penicillin g benzathine and penicillin g procaine, 100,000 units
- J0561 — Injection, penicillin g benzathine, 100,000 units
- J0565 — Injection, bezlotoxumab, 10 mg
- J0567 — Injection, cerliponase alfa, 1 mg
- J0570 — Buprenorphine implant, 74.2 mg
- J0571 — Buprenorphine, oral, 1 mg
- J0572 — Buprenorphine/naloxone, oral, less than or equal to 3 mg buprenorphine
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Next steps
- Run a reimbursement report for a device billed under J0517
- Watch J0517 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0517
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.