J0583 HCPCS code: Injection, bivalirudin, 1 mg
J0583 is the HCPCS Level II code for injection, bivalirudin, 1 mg. In 2024 Medicare paid an average of $0.17 per service for J0583 across 3,650 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 1250 per day on outpatient hospital claims. Medicare volume fell 87% from 2022 to 2024 (28,779 to 3,650 services). In 2024, about 4 clinicians billed Medicare for J0583 for 15 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 | 2004-01-01 |
| Last action effective | 2018-01-01 |
Who bills J0583 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 4 |
| Medicare beneficiaries | 15 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0583, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 28,779 | 73 | $0.37 | $0.29 |
| 2023 | 17,550 | 48 | $0.22 | $0.17 |
| 2024 | 3,650 | 15 | $0.21 | $0.17 |
States with the most J0583 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 3,500 | $0.17 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1250 | Clinical: Data |
| practitioner claims | 250 | Clinical: Data |
What changed for J0583
- 2004-01-01: J0583 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 J0583?
J0583 is the HCPCS Level II code for injection, bivalirudin, 1 mg. Short descriptor: "Bivalirudin".
How much does Medicare pay for J0583?
In 2024, the average Medicare payment was $0.17 per service (average allowed $0.21).
Does Medicare cover J0583?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0583 can be billed per day?
1250 on outpatient hospital claims; 250 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
- J0517 — Injection, benralizumab, 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
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Next steps
- Run a reimbursement report for a device billed under J0583
- Watch J0583 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0583
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.