J1071 HCPCS code: Injection, testosterone cypionate, 1 mg
J1071 is the HCPCS Level II code for injection, testosterone cypionate, 1 mg. In 2024 Medicare paid an average of $0.02 per service for J1071 across 54,294,281 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 400 per day on outpatient hospital claims. Medicare volume fell 17% from 2022 to 2024 (65,309,843 to 54,294,281 services). In 2024, about 16,351 clinicians billed Medicare for J1071 for 32,107 beneficiaries; California, Texas, New York accounted for 31% 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 | 2015-01-01 |
| Last action effective | 2015-01-01 |
Who bills J1071 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 16,351 |
| Medicare beneficiaries | 32,107 |
| States with claims | 49 |
| Share of services in top 3 states (California, Texas, New York) | 31% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1071, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 65,309,843 | 39,012 | $0.03 | $0.02 |
| 2023 | 58,835,484 | 35,476 | $0.03 | $0.02 |
| 2024 | 54,294,281 | 32,107 | $0.02 | $0.02 |
States with the most J1071 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 8,314,142 | $0.02 |
| Texas | 5,284,647 | $0.02 |
| New York | 3,420,667 | $0.02 |
| Florida | 3,373,346 | $0.02 |
| Tennessee | 3,264,187 | $0.02 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 400 | Prescribing Information |
| practitioner claims | 400 | Prescribing Information |
Medicare policy articles for this code
- A57615: Billing and Coding: Treatment of Males with Low Testosterone (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B))
- A58828: Billing and Coding: Treatment of Males with Low Testosterone (Palmetto GBA (MAC - Part A, MAC - Part B))
- A58828: Billing and Coding: Treatment of Males with Low Testosterone (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (40 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| D35.2 | Benign neoplasm of pituitary gland | 2 |
| D44.3 | Neoplasm of uncertain behavior of pituitary gland | 2 |
| E23.0 | Hypopituitarism | 2 |
| E23.1 | Drug-induced hypopituitarism | 2 |
| E23.3 | Hypothalamic dysfunction, not elsewhere classified | 2 |
| E23.6 | Other disorders of pituitary gland | 2 |
| E23.7 | Disorder of pituitary gland, unspecified | 2 |
| E29.1 | Testicular hypofunction | 2 |
| E29.8 | Other testicular dysfunction | 2 |
| E89.5 | Postprocedural testicular hypofunction | 2 |
Showing 10 of 40. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1071
- 2015-01-01: J1071 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 J1071?
J1071 is the HCPCS Level II code for injection, testosterone cypionate, 1 mg. Short descriptor: "Inj testosterone cypionate".
How much does Medicare pay for J1071?
In 2024, the average Medicare payment was $0.02 per service (average allowed $0.02).
Does Medicare cover J1071?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J1071?
Medicare policy articles that cite J1071 list 40 covered ICD-10-CM diagnosis codes across 3 articles. The most cited include D35.2 (Benign neoplasm of pituitary gland), D44.3 (Neoplasm of uncertain behavior of pituitary gland), E23.0 (Hypopituitarism). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J1071 can be billed per day?
400 on outpatient hospital claims; 400 on practitioner claims (NCCI medically unlikely edits).
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
- 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
- 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
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Next steps
- Run a reimbursement report for a device billed under J1071
- Watch J1071 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1071
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.