J1652 HCPCS code: Injection, fondaparinux sodium, 0.5 mg
J1652 is the HCPCS Level II code for injection, fondaparinux sodium, 0.5 mg. In 2024 Medicare paid an average of $0.78 per service for J1652 across 2,106 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 20 per day on outpatient hospital claims. Medicare volume fell 48% from 2022 to 2024 (4,025 to 2,106 services). In 2024, about 48 clinicians billed Medicare for J1652 for 28 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 | 2003-01-01 |
| Last action effective | 2003-01-01 |
Who bills J1652 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 48 |
| Medicare beneficiaries | 28 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1652, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 4,025 | 57 | $1.22 | $0.96 |
| 2023 | 2,052 | 29 | $1.02 | $0.81 |
| 2024 | 2,106 | 28 | $1.01 | $0.78 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 20 | Prescribing Information |
| practitioner claims | 20 | Prescribing Information |
What changed for J1652
- 2003-01-01: J1652 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 J1652?
J1652 is the HCPCS Level II code for injection, fondaparinux sodium, 0.5 mg. Short descriptor: "Fondaparinux sodium".
How much does Medicare pay for J1652?
In 2024, the average Medicare payment was $0.78 per service (average allowed $1.01).
Does Medicare cover J1652?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1652 can be billed per day?
20 on outpatient hospital claims; 20 on practitioner claims (NCCI medically unlikely edits).
Related J16 codes
- J1600 — Injection, gold sodium thiomalate, up to 50 mg
- J1602 — Injection, golimumab, 1 mg, for intravenous use
- J1610 — Injection, glucagon hydrochloride, per 1 mg
- J1611 — Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg
- J1612 — Injection, glucagon (gvoke), 0.01 mg
- J1620 — Injection, gonadorelin hydrochloride, per 100 mcg
- J1626 — Injection, granisetron hydrochloride, 100 mcg
- J1627 — Injection, granisetron, extended-release, 0.1 mg
- J1628 — Injection, guselkumab, 1 mg
- J1630 — Injection, haloperidol, up to 5 mg
- J1631 — Injection, haloperidol decanoate, per 50 mg
- J1632 — Injection, brexanolone, 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 J1652
- Watch J1652 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1652
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.