J1170 HCPCS code: Injection, hydromorphone, up to 4 mg
J1170 is the HCPCS Level II code for injection, hydromorphone, up to 4 mg. CMS terminated J1170 on 2024-09-30; do not bill it for later dates of service. In 2024 Medicare paid an average of $2.78 per service for J1170 across 162,172 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 34% from 2022 to 2024 (245,939 to 162,172 services). In 2024, 21 suppliers billed Medicare for J1170 (purchases), serving 31 beneficiaries; Maryland, Maine, California accounted for 76% 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 | 2024-10-01 |
| Terminated | 2024-09-30 |
Who bills J1170 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 21 |
| Referring clinicians | 51 |
| Medicare beneficiaries | 31 |
| States with claims | 7 |
| Share of services in top 3 states (Maryland, Maine, California) | 76% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 40 | 69 |
| 2023 | 25 | 41 |
| 2024 | 21 | 31 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1170, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 245,939 | 3,342 | $2.78 | $2.17 |
| 2023 | 233,527 | 3,171 | $3.56 | $2.80 |
| 2024 | 162,172 | 2,668 | $3.56 | $2.78 |
States with the most J1170 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Kentucky | 40,321 | $2.98 |
| California | 24,706 | $2.64 |
| Florida | 22,982 | $3.03 |
| Pennsylvania | 15,494 | $2.52 |
| Arizona | 10,929 | $2.17 |
What changed for J1170
- 1982-01-01: J1170 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 J1170?
J1170 is the HCPCS Level II code for injection, hydromorphone, up to 4 mg. Short descriptor: "Hydromorphone injection".
How much does Medicare pay for J1170?
In 2024, the average Medicare payment was $2.78 per service (average allowed $3.56).
Does Medicare cover J1170?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
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
- J1160 — Injection, digoxin, up to 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
- 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 J1170
- Watch J1170 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1170
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.