J2003 HCPCS code: Injection, lidocaine hydrochloride, 1 mg
J2003 is the HCPCS Level II code for injection, lidocaine hydrochloride, 1 mg. In 2024 Medicare paid an average of $0.47 per service for J2003 across 39,153 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 300 per day on outpatient hospital claims. In 2024, about 162 clinicians billed Medicare for J2003 for 1,117 beneficiaries; Kansas, Florida, Pennsylvania accounted for 92% 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 | 2024-10-01 |
| Last action effective | 2024-10-01 |
Who bills J2003 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 162 |
| Medicare beneficiaries | 1,117 |
| States with claims | 8 |
| Share of services in top 3 states (Kansas, Florida, Pennsylvania) | 92% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2003, 2024–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2024 | 39,153 | 1,117 | $0.60 | $0.47 |
States with the most J2003 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Kansas | 29,386 | $0.19 |
| Florida | 4,968 | $1.44 |
| Pennsylvania | 1,472 | $1.94 |
| Michigan | 1,146 | $0.11 |
| New Jersey | 978 | $1.65 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 300 | Clinical: CMS Workgroup |
| practitioner claims | 300 | Clinical: CMS Workgroup |
What changed for J2003
- 2024-10-01: J2003 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 J2003?
J2003 is the HCPCS Level II code for injection, lidocaine hydrochloride, 1 mg. Short descriptor: "Inj, lidocaine hcl, 1 mg".
How much does Medicare pay for J2003?
In 2024, the average Medicare payment was $0.47 per service (average allowed $0.60).
Does Medicare cover J2003?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J2003 can be billed per day?
300 on outpatient hospital claims; 300 on practitioner claims (NCCI medically unlikely edits).
Related J20 codes
- J2001 — Injection, lidocaine hcl for intravenous infusion, 10 mg
- J2002 — Injection, lidocaine hcl in 5% dextrose, 1 mg
- J2004 — Injection, lidocaine hcl with epinephrine, 1 mg
- J2010 — Injection, lincomycin hcl, up to 300 mg
- J2020 — Injection, linezolid, 200 mg
- J2021 — Injection, linezolid (hospira), not therapeutically equivalent to j2020, 200 mg
- J2060 — Injection, lorazepam, 2 mg
- J2062 — Loxapine for inhalation, 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 J2003
- Watch J2003 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2003
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.