J1950 HCPCS code: Injection, leuprolide acetate (for depot suspension), per 3.75 mg
J1950 is the HCPCS Level II code for injection, leuprolide acetate (for depot suspension), per 3.75 mg. In 2024 Medicare paid an average of $991.48 per service for J1950 across 2,402 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 12 per day on outpatient hospital claims. Medicare volume rose 25% from 2022 to 2024 (1,929 to 2,402 services). In 2024, about 392 clinicians billed Medicare for J1950 for 348 beneficiaries; California, Washington, Florida accounted for 72% of services.
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 | 1986-01-01 |
| Last action effective | 1997-01-01 |
Who bills J1950 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 392 |
| Medicare beneficiaries | 348 |
| States with claims | 9 |
| Share of services in top 3 states (California, Washington, Florida) | 72% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1950, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,929 | 335 | $1,145.15 | $911.19 |
| 2023 | 2,235 | 344 | $1,209.21 | $963.20 |
| 2024 | 2,402 | 348 | $1,234.60 | $991.48 |
States with the most J1950 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 563 | $1,114.86 |
| Washington | 343 | $80.83 |
| Florida | 305 | $1,229.50 |
| South Carolina | 98 | $1,263.07 |
| New Jersey | 96 | $1,235.20 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 12 | Clinical: Data |
| practitioner claims | 12 | Clinical: Data |
Medicare policy articles for this code
- A52453: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (Wellpoint Federal (MAC - Part A, MAC - Part B))
- A59160: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (Palmetto GBA (MAC - Part A, MAC - Part B))
Covered diagnoses (246 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C08.0 | Malignant neoplasm of submandibular gland | 2 |
| C08.1 | Malignant neoplasm of sublingual gland | 2 |
| C48.1 | Malignant neoplasm of specified parts of peritoneum | 2 |
| C48.8 | Malignant neoplasm of overlapping sites of retroperitoneum and peritoneum | 2 |
| C50.011 | Malignant neoplasm of nipple and areola, right female breast | 2 |
| C50.012 | Malignant neoplasm of nipple and areola, left female breast | 2 |
| C50.021 | Malignant neoplasm of nipple and areola, right male breast | 2 |
| C50.022 | Malignant neoplasm of nipple and areola, left male breast | 2 |
| C50.111 | Malignant neoplasm of central portion of right female breast | 2 |
| C50.112 | Malignant neoplasm of central portion of left female breast | 2 |
Showing 10 of 246. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1950
- 1986-01-01: J1950 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 J1950?
J1950 is the HCPCS Level II code for injection, leuprolide acetate (for depot suspension), per 3.75 mg. Short descriptor: "Leuprolide acetate /3.75 mg".
How much does Medicare pay for J1950?
In 2024, the average Medicare payment was $991.48 per service (average allowed $1,234.60).
Does Medicare cover J1950?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J1950?
Medicare policy articles that cite J1950 list 246 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include C08.0 (Malignant neoplasm of submandibular gland), C08.1 (Malignant neoplasm of sublingual gland), C48.1 (Malignant neoplasm of specified parts of peritoneum). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J1950 can be billed per day?
12 on outpatient hospital claims; 12 on practitioner claims (NCCI medically unlikely edits).
Related J19 codes
- J1920 — Injection, labetalol hydrochloride, 5 mg
- J1921 — Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg
- J1930 — Injection, lanreotide, 1 mg
- J1931 — Injection, laronidase, 0.1 mg
- J1932 — Injection, lanreotide, (cipla), 1 mg
- J1938 — Injection, furosemide, 1 mg
- J1939 — Injection, bumetanide, 0.5 mg
- J1940 — Injection, furosemide, up to 20 mg
- J1941 — Injection, furosemide (furoscix), 20 mg
- J1942 — Injection, aripiprazole lauroxil, 1 mg
- J1943 — Injection, aripiprazole lauroxil, (aristada initio), 1 mg
- J1944 — Injection, aripiprazole lauroxil, (aristada), 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 J1950
- Watch J1950 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1950
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.