J1747 HCPCS code: Injection, spesolimab-sbzo, 1 mg
J1747 is the HCPCS Level II code for injection, spesolimab-sbzo, 1 mg. In 2024 Medicare paid an average of $46.87 per service for J1747 across 57,902 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 900 per day on outpatient hospital claims. Medicare volume rose 143% from 2023 to 2024 (23,851 to 57,902 services). In 2024, about 41 clinicians billed Medicare for J1747 for 33 beneficiaries.
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 | 2023-04-01 |
| Last action effective | 2023-04-01 |
Who bills J1747 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 41 |
| Medicare beneficiaries | 33 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1747, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 23,851 | 17 | $59.26 | $47.21 |
| 2024 | 57,902 | 33 | $58.83 | $46.87 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 900 | Prescribing Information |
| practitioner claims | 900 | Prescribing Information |
What changed for J1747
- 2023-04-01: J1747 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 J1747?
J1747 is the HCPCS Level II code for injection, spesolimab-sbzo, 1 mg. Short descriptor: "Inj, spesolimab-sbzo, 1 mg".
How much does Medicare pay for J1747?
In 2024, the average Medicare payment was $46.87 per service (average allowed $58.83).
Does Medicare cover J1747?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1747 can be billed per day?
900 on outpatient hospital claims; 900 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
- J1736 — Injection, meloxicam (delova), 1 mg
- J1737 — Injection, meloxicam (azurity), 1 mg
- J1738 — Injection, meloxicam, 1 mg
- J1740 — Injection, ibandronate sodium, 1 mg
- J1741 — Injection, ibuprofen, 100 mg
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Next steps
- Run a reimbursement report for a device billed under J1747
- Watch J1747 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1747
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.