J1160 HCPCS code: Injection, digoxin, up to 0.5 mg
J1160 is the HCPCS Level II code for injection, digoxin, up to 0.5 mg. In 2024 Medicare paid an average of $7.82 per service for J1160 across 23 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 3 per day on outpatient hospital claims. Medicare volume fell 23% from 2022 to 2024 (30 to 23 services). In 2024, about 16 clinicians billed Medicare for J1160 for 17 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 | 1982-01-01 |
| Last action effective | 1997-01-01 |
Who bills J1160 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 16 |
| Medicare beneficiaries | 17 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1160, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 30 | 23 | $13.50 | $10.20 |
| 2023 | 19 | 17 | $7.80 | $6.25 |
| 2024 | 23 | 17 | $9.81 | $7.82 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 3 | Prescribing Information |
| practitioner claims | 2 | Prescribing Information |
What changed for J1160
- 1982-01-01: J1160 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 J1160?
J1160 is the HCPCS Level II code for injection, digoxin, up to 0.5 mg. Short descriptor: "Digoxin injection".
How much does Medicare pay for J1160?
In 2024, the average Medicare payment was $7.82 per service (average allowed $9.81).
Does Medicare cover J1160?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1160 can be billed per day?
3 on outpatient hospital claims; 2 on practitioner claims (NCCI medically unlikely edits).
Related J11 codes
- J1100 — Injection, dexamethasone sodium phosphate, 1 mg
- J1105 — Dexmedetomidine, oral, 1 mcg
- J1110 — Injection, dihydroergotamine mesylate, per 1 mg
- J1120 — Injection, acetazolamide sodium, up to 500 mg
- J1130 — Injection, diclofenac sodium, 0.5 mg
- J1162 — Injection, digoxin immune fab (ovine), per vial
- J1163 — Injection, diltiazem hydrochloride, 0.5 mg
- J1165 — Injection, phenytoin sodium, per 50 mg
- J1170 — Injection, hydromorphone, up to 4 mg
- J1171 — Injection, hydromorphone, 0.1 mg
- J1180 — Injection, dyphylline, up to 500 mg
- J1190 — Injection, dexrazoxane hydrochloride, per 250 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 J1160
- Watch J1160 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1160
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.