J1437 HCPCS code: Injection, ferric derisomaltose, 10 mg
J1437 is the HCPCS Level II code for injection, ferric derisomaltose, 10 mg. In 2024 Medicare paid an average of $15.76 per service for J1437 across 4,340,076 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 100 per day on outpatient hospital claims. Medicare volume rose 390% from 2022 to 2024 (885,360 to 4,340,076 services). In 2024, about 2,542 clinicians billed Medicare for J1437 for 33,356 beneficiaries; Florida, Tennessee, Maryland accounted for 35% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2020-10-01 |
| Last action effective | 2023-01-01 |
Who bills J1437 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,542 |
| Medicare beneficiaries | 33,356 |
| States with claims | 44 |
| Share of services in top 3 states (Florida, Tennessee, Maryland) | 35% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1437, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 885,360 | 6,758 | $23.17 | $18.46 |
| 2023 | 2,560,139 | 19,962 | $20.68 | $16.46 |
| 2024 | 4,340,076 | 33,356 | $19.82 | $15.76 |
States with the most J1437 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 743,317 | $15.77 |
| Tennessee | 426,650 | $15.89 |
| Maryland | 359,765 | $15.69 |
| Pennsylvania | 285,320 | $15.74 |
| Texas | 281,199 | $16.08 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 100 | Prescribing Information |
| practitioner claims | 100 | Prescribing Information |
What changed for J1437
- 2020-10-01: J1437 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 J1437?
J1437 is the HCPCS Level II code for injection, ferric derisomaltose, 10 mg. Short descriptor: "Inj. fe derisomaltose 10 mg".
How much does Medicare pay for J1437?
In 2024, the average Medicare payment was $15.76 per service (average allowed $19.82).
Does Medicare cover J1437?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1437 can be billed per day?
100 on outpatient hospital claims; 100 on practitioner claims (NCCI medically unlikely edits).
Related J14 codes
- J1410 — Injection, estrogen conjugated, per 25 mg
- J1411 — Injection, etranacogene dezaparvovec-drlb, per therapeutic dose
- J1412 — Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes
- J1413 — Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose
- J1414 — Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose
- J1426 — Injection, casimersen, 10 mg
- J1427 — Injection, viltolarsen, 10 mg
- J1428 — Injection, eteplirsen, 10 mg
- J1429 — Injection, golodirsen, 10 mg
- J1430 — Injection, ethanolamine oleate, 100 mg
- J1434 — Injection, fosaprepitant (focinvez), 1 mg
- J1435 — Injection, estrone, per 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 J1437
- Watch J1437 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1437
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.