J1000 HCPCS code: Injection, depo-estradiol cypionate, up to 5 mg
J1000 is the HCPCS Level II code for injection, depo-estradiol cypionate, up to 5 mg. In 2024 Medicare paid an average of $21.51 per service for J1000 across 3,802 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 1 per day on outpatient hospital claims. Medicare volume fell 40% from 2022 to 2024 (6,313 to 3,802 services). In 2024, about 430 clinicians billed Medicare for J1000 for 816 beneficiaries; California, Louisiana, Georgia accounted for 54% of services.
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 | 1982-01-01 |
| Last action effective | 1997-01-01 |
Who bills J1000 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 430 |
| Medicare beneficiaries | 816 |
| States with claims | 13 |
| Share of services in top 3 states (California, Louisiana, Georgia) | 54% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1000, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 6,313 | 1,262 | $21.49 | $14.40 |
| 2023 | 4,028 | 840 | $25.94 | $18.12 |
| 2024 | 3,802 | 816 | $30.14 | $21.51 |
States with the most J1000 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 662 | $25.24 |
| Louisiana | 581 | $24.87 |
| Georgia | 445 | $20.76 |
| Missouri | 318 | $17.89 |
| Texas | 301 | $20.35 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Prescribing Information |
| practitioner claims | 1 | Prescribing Information |
What changed for J1000
- 1982-01-01: J1000 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 J1000?
J1000 is the HCPCS Level II code for injection, depo-estradiol cypionate, up to 5 mg. Short descriptor: "Depo-estradiol cypionate inj".
How much does Medicare pay for J1000?
In 2024, the average Medicare payment was $21.51 per service (average allowed $30.14).
Does Medicare cover J1000?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1000 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related J10 codes
- J1010 — Injection, methylprednisolone acetate, 1 mg
- J1020 — Injection, methylprednisolone acetate, 20 mg
- J1030 — Injection, methylprednisolone acetate, 40 mg
- J1040 — Injection, methylprednisolone acetate, 80 mg
- J1050 — Injection, medroxyprogesterone acetate, 1 mg
- J1060 — Injection, testosterone cypionate and estradiol cypionate, up to 1 ml
- J1070 — Injection, testosterone cypionate, up to 100 mg
- J1071 — Injection, testosterone cypionate, 1 mg
- J1072 — Injection, testosterone cypionate (azmiro), 1 mg
- J1080 — Injection, testosterone cypionate, 1 cc, 200 mg
- J1094 — Injection, dexamethasone acetate, 1 mg
- J1095 — Injection, dexamethasone 9 percent, intraocular, 1 microgram
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J1000
- Watch J1000 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1000
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.