J1171 HCPCS code: Injection, hydromorphone, 0.1 mg
J1171 is the HCPCS Level II code for injection, hydromorphone, 0.1 mg. In 2024 Medicare paid an average of $0.06 per service for J1171 across 751,495 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 240 per day on DME suppliers. In 2024, 10 suppliers billed Medicare for J1171 (purchases), serving 13 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 | 2024-10-01 |
| Last action effective | 2025-01-01 |
Who bills J1171 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 10 |
| Referring clinicians | 20 |
| Medicare beneficiaries | 13 |
| States with claims | 4 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1171, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 751,495 | 931 | $0.08 | $0.06 |
States with the most J1171 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Kentucky | 349,572 | $0.07 |
| Arizona | 92,997 | $0.06 |
| California | 61,243 | $0.05 |
| Ohio | 46,677 | $0.06 |
| Maryland | 45,531 | $0.07 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 240 | Prescribing Information |
| outpatient hospital claims | 240 | Prescribing Information |
| practitioner claims | 240 | Prescribing Information |
What changed for J1171
- 2024-10-01: J1171 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 J1171?
J1171 is the HCPCS Level II code for injection, hydromorphone, 0.1 mg. Short descriptor: "Inj, hydromorphone, 0.1 mg".
How much does Medicare pay for J1171?
In 2024, the average Medicare payment was $0.06 per service (average allowed $0.08).
Does Medicare cover J1171?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1171 can be billed per day?
240 on DME suppliers; 240 on outpatient hospital claims; 240 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
- 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
- J1170 — Injection, hydromorphone, up to 4 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 J1171
- Watch J1171 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1171
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.