J1740 HCPCS code: Injection, ibandronate sodium, 1 mg
J1740 is the HCPCS Level II code for injection, ibandronate sodium, 1 mg. In 2024 Medicare paid an average of $19.49 per service for J1740 across 4,506 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 3 per day on outpatient hospital claims. Medicare volume fell 35% from 2022 to 2024 (6,925 to 4,506 services). In 2024, about 328 clinicians billed Medicare for J1740 for 625 beneficiaries; New York, California, Florida accounted for 32% 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 | 2007-01-01 |
| Last action effective | 2024-01-01 |
Who bills J1740 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 328 |
| Medicare beneficiaries | 625 |
| States with claims | 17 |
| Share of services in top 3 states (New York, California, Florida) | 32% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1740, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 6,925 | 923 | $33.10 | $24.49 |
| 2023 | 5,632 | 742 | $28.96 | $20.67 |
| 2024 | 4,506 | 625 | $27.33 | $19.49 |
States with the most J1740 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| New York | 541 | $21.55 |
| California | 361 | $19.59 |
| Florida | 351 | $20.29 |
| New Jersey | 335 | $19.41 |
| Minnesota | 282 | $20.18 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 3 | Prescribing Information |
| practitioner claims | 3 | Prescribing Information |
Medicare policy articles for this code
- A52421: Billing and Coding: Ibandronate Sodium (National Government Services, Inc. (MAC - Part A, MAC - Part B))
- A56907: Billing and Coding: Bisphosphonate Drug Therapy (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
Covered diagnoses (410 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C79.51 | Secondary malignant neoplasm of bone | 2 |
| E83.52 | Hypercalcemia | 2 |
| M80.011A | Age-related osteoporosis with current pathological fracture, right shoulder, initial encounter for fracture | 2 |
| M80.012A | Age-related osteoporosis with current pathological fracture, left shoulder, initial encounter for fracture | 2 |
| M80.021A | Age-related osteoporosis with current pathological fracture, right humerus, initial encounter for fracture | 2 |
| M80.022A | Age-related osteoporosis with current pathological fracture, left humerus, initial encounter for fracture | 2 |
| M80.031A | Age-related osteoporosis with current pathological fracture, right forearm, initial encounter for fracture | 2 |
| M80.032A | Age-related osteoporosis with current pathological fracture, left forearm, initial encounter for fracture | 2 |
| M80.041A | Age-related osteoporosis with current pathological fracture, right hand, initial encounter for fracture | 2 |
| M80.042A | Age-related osteoporosis with current pathological fracture, left hand, initial encounter for fracture | 2 |
Showing 10 of 410. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1740
- 2007-01-01: J1740 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 J1740?
J1740 is the HCPCS Level II code for injection, ibandronate sodium, 1 mg. Short descriptor: "Ibandronate sodium injection".
How much does Medicare pay for J1740?
In 2024, the average Medicare payment was $19.49 per service (average allowed $27.33).
Does Medicare cover J1740?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J1740?
Medicare policy articles that cite J1740 list 410 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include C79.51 (Secondary malignant neoplasm of bone), E83.52 (Hypercalcemia), M80.011A (Age-related osteoporosis with current pathological fracture, right shoulder, initial encounter for fracture). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J1740 can be billed per day?
3 on outpatient hospital claims; 3 on practitioner claims (NCCI medically unlikely edits).
Related J17 codes
- J1700 — Injection, hydrocortisone acetate, up to 25 mg
- J1710 — Injection, hydrocortisone sodium phosphate, up to 50 mg
- J1720 — Injection, hydrocortisone sodium succinate, up to 100 mg
- J1725 — Injection, hydroxyprogesterone caproate, 1 mg
- J1726 — Injection, hydroxyprogesterone caproate, (makena), 10 mg
- J1729 — Injection, hydroxyprogesterone caproate, not otherwise specified, 10 mg
- J1730 — Injection, diazoxide, up to 300 mg
- J1738 — Injection, meloxicam, 1 mg
- J1741 — Injection, ibuprofen, 100 mg
- J1742 — Injection, ibutilide fumarate, 1 mg
- J1743 — Injection, idursulfase, 1 mg
- J1744 — Injection, icatibant, 1 mg
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Next steps
- Run a reimbursement report for a device billed under J1740
- Watch J1740 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1740
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.