J1040 HCPCS code: Injection, methylprednisolone acetate, 80 mg
J1040 is the HCPCS Level II code for injection, methylprednisolone acetate, 80 mg. CMS terminated J1040 on 2024-03-31; do not bill it for later dates of service. In 2024 Medicare paid an average of $5.89 per service for J1040 across 201,270 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. Medicare volume fell 74% from 2022 to 2024 (788,195 to 201,270 services). In 2024, about 16,912 clinicians billed Medicare for J1040 for 154,074 beneficiaries; Florida, Texas, Georgia accounted for 28% 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 | 2024-04-01 |
| Terminated | 2024-03-31 |
Who bills J1040 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 16,912 |
| Medicare beneficiaries | 154,074 |
| States with claims | 52 |
| Share of services in top 3 states (Florida, Texas, Georgia) | 28% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1040, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 788,195 | 457,586 | $10.83 | $8.03 |
| 2023 | 841,014 | 475,893 | $11.58 | $8.62 |
| 2024 | 201,270 | 154,074 | $9.59 | $5.89 |
States with the most J1040 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 27,615 | $6.66 |
| Texas | 18,803 | $5.43 |
| Georgia | 10,302 | $5.50 |
| Tennessee | 9,989 | $5.51 |
| California | 9,874 | $6.56 |
What changed for J1040
- 1982-01-01: J1040 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 J1040?
J1040 is the HCPCS Level II code for injection, methylprednisolone acetate, 80 mg. Short descriptor: "Methylprednisolone 80 mg inj".
How much does Medicare pay for J1040?
In 2024, the average Medicare payment was $5.89 per service (average allowed $9.59).
Does Medicare cover J1040?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Related J10 codes
- J1000 — Injection, depo-estradiol cypionate, up to 5 mg
- J1010 — Injection, methylprednisolone acetate, 1 mg
- J1020 — Injection, methylprednisolone acetate, 20 mg
- J1030 — Injection, methylprednisolone acetate, 40 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
- J1073 — Testosterone pellet, implant, 75 mg
- J1080 — Injection, testosterone cypionate, 1 cc, 200 mg
- J1094 — Injection, dexamethasone acetate, 1 mg
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 J1040
- Watch J1040 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1040
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.