J1823 HCPCS code: Injection, inebilizumab-cdon, 1 mg
J1823 is the HCPCS Level II code for injection, inebilizumab-cdon, 1 mg. In 2024 Medicare paid an average of $363.15 per service for J1823 across 54,956 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 300 per day on outpatient hospital claims. Medicare volume rose 89% from 2022 to 2024 (29,108 to 54,956 services). In 2024, about 114 clinicians billed Medicare for J1823 for 98 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 | 2021-01-01 |
| Last action effective | 2021-01-01 |
Who bills J1823 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 114 |
| Medicare beneficiaries | 98 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1823, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 29,108 | 53 | $446.60 | $356.59 |
| 2023 | 43,527 | 80 | $420.12 | $334.68 |
| 2024 | 54,956 | 98 | $455.84 | $363.15 |
States with the most J1823 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 16,950 | $365.04 |
| Florida | 5,300 | $345.42 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 300 | Prescribing Information |
| practitioner claims | 300 | Prescribing Information |
What changed for J1823
- 2021-01-01: J1823 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 J1823?
J1823 is the HCPCS Level II code for injection, inebilizumab-cdon, 1 mg. Short descriptor: "Inj. inebilizumab-cdon, 1 mg".
How much does Medicare pay for J1823?
In 2024, the average Medicare payment was $363.15 per service (average allowed $455.84).
Does Medicare cover J1823?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1823 can be billed per day?
300 on outpatient hospital claims; 300 on practitioner claims (NCCI medically unlikely edits).
Related J18 codes
- J1800 — Injection, propranolol hcl, up to 1 mg
- J1805 — Injection, esmolol hydrochloride, 10 mg
- J1806 — Injection, esmolol hydrochloride (wg critical care), not therapeutically equivalent to j1805, 10 mg
- J1807 — Injection, ethacrynate sodium, 1 mg
- J1808 — Injection, folic acid, 0.1 mg
- J1809 — Injection, fosdenopterin, 0.1 mg
- J1810 — Injection, droperidol and fentanyl citrate, up to 2 ml ampule
- J1811 — Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units
- J1812 — Insulin (fiasp), per 5 units
- J1813 — Insulin (lyumjev) for administration through dme (i.e., insulin pump) per 50 units
- J1814 — Insulin (lyumjev), per 5 units
- J1815 — Injection, insulin, per 5 units
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Next steps
- Run a reimbursement report for a device billed under J1823
- Watch J1823 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1823
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.