J1453 HCPCS code: Injection, fosaprepitant, 1 mg
J1453 is the HCPCS Level II code for injection, fosaprepitant, 1 mg. In 2024 Medicare paid an average of $0.11 per service for J1453 across 15,783,511 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 150 per day on outpatient hospital claims. Medicare volume fell 5% from 2022 to 2024 (16,587,237 to 15,783,511 services). In 2024, about 3,978 clinicians billed Medicare for J1453 for 21,676 beneficiaries; Texas, California, Florida accounted for 37% 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 | 2009-01-01 |
| Last action effective | 2022-01-01 |
Who bills J1453 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 3,978 |
| Medicare beneficiaries | 21,676 |
| States with claims | 49 |
| Share of services in top 3 states (Texas, California, Florida) | 37% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1453, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 16,587,237 | 24,165 | $0.17 | $0.14 |
| 2023 | 15,793,057 | 22,459 | $0.15 | $0.12 |
| 2024 | 15,783,511 | 21,676 | $0.14 | $0.11 |
States with the most J1453 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 3,300,925 | $0.11 |
| California | 1,537,091 | $0.11 |
| Florida | 986,113 | $0.11 |
| Illinois | 972,915 | $0.11 |
| Arizona | 731,431 | $0.11 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 150 | Prescribing Information |
| practitioner claims | 150 | Prescribing Information |
What changed for J1453
- 2009-01-01: J1453 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 J1453?
J1453 is the HCPCS Level II code for injection, fosaprepitant, 1 mg. Short descriptor: "Fosaprepitant injection".
How much does Medicare pay for J1453?
In 2024, the average Medicare payment was $0.11 per service (average allowed $0.14).
Does Medicare cover J1453?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1453 can be billed per day?
150 on outpatient hospital claims; 150 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
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Next steps
- Run a reimbursement report for a device billed under J1453
- Watch J1453 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1453
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.