J0584 HCPCS code: Injection, burosumab-twza 1 mg
J0584 is the HCPCS Level II code for injection, burosumab-twza 1 mg. In 2024 Medicare paid an average of $359.54 per service for J0584 across 29,138 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 90 per day on outpatient hospital claims. Medicare volume rose 7% from 2022 to 2024 (27,307 to 29,138 services). In 2024, about 91 clinicians billed Medicare for J0584 for 45 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 | 2019-01-01 |
| Last action effective | 2019-01-01 |
Who bills J0584 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 91 |
| Medicare beneficiaries | 45 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0584, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 27,307 | 45 | $386.43 | $308.37 |
| 2023 | 29,043 | 53 | $414.44 | $330.55 |
| 2024 | 29,138 | 45 | $446.26 | $359.54 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 90 | Prescribing Information |
| practitioner claims | 90 | Prescribing Information |
What changed for J0584
- 2019-01-01: J0584 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 J0584?
J0584 is the HCPCS Level II code for injection, burosumab-twza 1 mg. Short descriptor: "Injection, burosumab-twza 1m".
How much does Medicare pay for J0584?
In 2024, the average Medicare payment was $359.54 per service (average allowed $446.26).
Does Medicare cover J0584?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0584 can be billed per day?
90 on outpatient hospital claims; 90 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
- 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 J0584
- Watch J0584 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0584
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.