J0712 HCPCS code: Injection, ceftaroline fosamil, 10 mg
J0712 is the HCPCS Level II code for injection, ceftaroline fosamil, 10 mg. In 2024 Medicare paid an average of $3.04 per service for J0712 across 42,341 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 180 per day on outpatient hospital claims. Medicare volume rose 49% from 2022 to 2024 (28,405 to 42,341 services). In 2024, about 26 clinicians billed Medicare for J0712 for 22 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 | 2012-01-01 |
| Last action effective | 2016-01-01 |
Who bills J0712 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 26 |
| Medicare beneficiaries | 22 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0712, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 28,405 | 26 | $3.60 | $2.87 |
| 2023 | 22,073 | 16 | $3.76 | $2.99 |
| 2024 | 42,341 | 22 | $3.82 | $3.04 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 180 | Prescribing Information |
| practitioner claims | 120 | Prescribing Information |
What changed for J0712
- 2012-01-01: J0712 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 J0712?
J0712 is the HCPCS Level II code for injection, ceftaroline fosamil, 10 mg. Short descriptor: "Ceftaroline fosamil inj".
How much does Medicare pay for J0712?
In 2024, the average Medicare payment was $3.04 per service (average allowed $3.82).
Does Medicare cover J0712?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J0712 can be billed per day?
180 on outpatient hospital claims; 120 on practitioner claims (NCCI medically unlikely edits).
Related J07 codes
- J0701 — Injection, cefepime hydrochloride (baxter), not therapeutically equivalent to maxipime, 500 mg
- J0702 — Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg
- J0703 — Injection, cefepime hydrochloride (b braun), not therapeutically equivalent to maxipime, 500 mg
- J0706 — Injection, caffeine citrate, 5 mg
- J0710 — Injection, cephapirin sodium, up to 1 gm
- J0713 — Injection, ceftazidime, per 500 mg
- J0714 — Injection, ceftazidime and avibactam, 0.5 g/0.125 g
- J0715 — Injection, ceftizoxime sodium, per 500 mg
- J0716 — Injection, centruroides immune f(ab)2, up to 120 milligrams
- J0717 — Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
- J0720 — Injection, chloramphenicol sodium succinate, up to 1 gm
- J0725 — Injection, chorionic gonadotropin, per 1,000 usp units
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Next steps
- Run a reimbursement report for a device billed under J0712
- Watch J0712 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0712
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.