J1836 HCPCS code: Injection, metronidazole, 10 mg
J1836 is the HCPCS Level II code for injection, metronidazole, 10 mg. In 2024 Medicare paid an average of $0.02 per service for J1836 across 33,481 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 400 per day on outpatient hospital claims. Medicare volume rose 539% from 2023 to 2024 (5,242 to 33,481 services). In 2024, about 120 clinicians billed Medicare for J1836 for 286 beneficiaries; Texas, California, New York accounted for 75% 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 | 2023-07-01 |
| Last action effective | 2024-01-01 |
Who bills J1836 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 120 |
| Medicare beneficiaries | 286 |
| States with claims | 9 |
| Share of services in top 3 states (Texas, California, New York) | 75% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1836, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 5,242 | 78 | $0.02 | $0.02 |
| 2024 | 33,481 | 286 | $0.03 | $0.02 |
States with the most J1836 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 9,954 | $0.02 |
| California | 5,200 | $0.02 |
| New York | 2,473 | $0.02 |
| New Jersey | 2,453 | $0.02 |
| Illinois | 820 | $0.02 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 400 | Prescribing Information |
| practitioner claims | 400 | Prescribing Information |
What changed for J1836
- 2023-07-01: J1836 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 J1836?
J1836 is the HCPCS Level II code for injection, metronidazole, 10 mg. Short descriptor: "Inj, metronidazole, 10 mg".
How much does Medicare pay for J1836?
In 2024, the average Medicare payment was $0.02 per service (average allowed $0.03).
Does Medicare cover J1836?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J1836 can be billed per day?
400 on outpatient hospital claims; 400 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
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 J1836
- Watch J1836 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1836
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.