J1952 HCPCS code: Leuprolide injectable, camcevi, 1 mg
J1952 is the HCPCS Level II code for leuprolide injectable, camcevi, 1 mg. In 2024 Medicare paid an average of $44.84 per service for J1952 across 537,148 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 42 per day on outpatient hospital claims. Medicare volume rose 1108% from 2022 to 2024 (44,451 to 537,148 services). In 2024, about 1,262 clinicians billed Medicare for J1952 for 9,037 beneficiaries; Illinois, New York, California accounted for 30% 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 | O1D — Chemotherapy |
| Added | 2022-01-01 |
| Last action effective | 2022-10-01 |
Who bills J1952 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,262 |
| Medicare beneficiaries | 9,037 |
| States with claims | 37 |
| Share of services in top 3 states (Illinois, New York, California) | 30% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1952, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 44,451 | 1,084 | $101.68 | $81.03 |
| 2023 | 338,316 | 6,341 | $81.24 | $64.67 |
| 2024 | 537,148 | 9,037 | $56.48 | $44.84 |
States with the most J1952 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Illinois | 58,608 | $44.87 |
| New York | 52,206 | $45.07 |
| California | 51,096 | $44.73 |
| Virginia | 49,026 | $44.60 |
| Indiana | 33,770 | $44.75 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 42 | Prescribing Information |
| practitioner claims | 42 | Prescribing Information |
Medicare policy articles for this code
- A52453: Billing and Coding: Luteinizing Hormone-Releasing Hormone (LHRH) Analogs (National Government Services, Inc. (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 J1952
- 2022-01-01: J1952 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 J1952?
J1952 is the HCPCS Level II code for leuprolide injectable, camcevi, 1 mg. Short descriptor: "Leuprolide inj, camcevi, 1mg".
How much does Medicare pay for J1952?
In 2024, the average Medicare payment was $44.84 per service (average allowed $56.48).
Does Medicare cover J1952?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J1952?
Medicare policy articles that cite J1952 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 J1952 can be billed per day?
42 on outpatient hospital claims; 42 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
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Next steps
- Run a reimbursement report for a device billed under J1952
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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.