J0743 HCPCS code: Injection, cilastatin sodium; imipenem, per 250 mg
J0743 is the HCPCS Level II code for injection, cilastatin sodium; imipenem, per 250 mg. In 2024 Medicare paid an average of $5.83 per service for J0743 across 12,283 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 16 per day on outpatient hospital claims. Medicare volume rose 27% from 2022 to 2024 (9,668 to 12,283 services). In 2024, about 86 clinicians billed Medicare for J0743 for 81 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 1993-01-01 |
| Last action effective | 1997-01-01 |
Who bills J0743 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 86 |
| Medicare beneficiaries | 81 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J0743, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 9,668 | 71 | $7.67 | $6.10 |
| 2023 | 9,347 | 67 | $7.47 | $5.94 |
| 2024 | 12,283 | 81 | $7.34 | $5.83 |
States with the most J0743 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 5,421 | $5.94 |
| Texas | 4,797 | $5.75 |
| Illinois | 27 | $6.06 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 16 | Prescribing Information |
| practitioner claims | 16 | Prescribing Information |
What changed for J0743
- 1993-01-01: J0743 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 J0743?
J0743 is the HCPCS Level II code for injection, cilastatin sodium; imipenem, per 250 mg. Short descriptor: "Cilastatin sodium injection".
How much does Medicare pay for J0743?
In 2024, the average Medicare payment was $5.83 per service (average allowed $7.34).
Does Medicare cover J0743?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J0743 can be billed per day?
16 on outpatient hospital claims; 16 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
- J0712 — Injection, ceftaroline fosamil, 10 mg
- 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
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Next steps
- Run a reimbursement report for a device billed under J0743
- Watch J0743 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J0743
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.