J1954 HCPCS code: Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg
J1954 is the HCPCS Level II code for injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg. In 2024 Medicare paid an average of $236.39 per service for J1954 across 6,638 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 3 per day on outpatient hospital claims. Medicare volume rose 151% from 2023 to 2024 (2,642 to 6,638 services). In 2024, about 224 clinicians billed Medicare for J1954 for 796 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 | O1D — Chemotherapy |
| Added | 2023-01-01 |
| Last action effective | 2025-07-01 |
Who bills J1954 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 224 |
| Medicare beneficiaries | 796 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1954, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 2,642 | 603 | $379.13 | $302.07 |
| 2024 | 6,638 | 796 | $299.11 | $236.39 |
States with the most J1954 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 5,578 | $235.68 |
| California | 988 | $241.01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 3 | Prescribing Information |
| practitioner claims | 3 | Prescribing Information |
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 J1954
- July 2025: Descriptor revised (Was: Injection, leuprolide acetate for depot suspension (cipla), 7.5 mg)
- 2023-01-01: J1954 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 J1954?
J1954 is the HCPCS Level II code for injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg. Short descriptor: "Inj leu acet lutr dpt 7.5 mg".
How much does Medicare pay for J1954?
In 2024, the average Medicare payment was $236.39 per service (average allowed $299.11).
Does Medicare cover J1954?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J1954?
Medicare policy articles that cite J1954 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 J1954 can be billed per day?
3 on outpatient hospital claims; 3 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
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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.