J3010 HCPCS code: Injection, fentanyl citrate, 0.1 mg
J3010 is the HCPCS Level II code for injection, fentanyl citrate, 0.1 mg. In 2024 Medicare paid an average of $0.71 per service for J3010 across 164,492 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 700 per day on DME suppliers. Medicare volume fell 52% from 2022 to 2024 (340,651 to 164,492 services). In 2024, about 1,958 clinicians billed Medicare for J3010 for 36,866 beneficiaries; California, Kentucky, Texas accounted for 41% 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 | 1982-01-01 |
| Last action effective | 2001-01-01 |
Who bills J3010 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,958 |
| Medicare beneficiaries | 36,866 |
| States with claims | 46 |
| Share of services in top 3 states (California, Kentucky, Texas) | 41% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3010, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 340,651 | 52,057 | $0.75 | $0.59 |
| 2023 | 236,332 | 45,290 | $0.87 | $0.69 |
| 2024 | 164,492 | 36,866 | $0.90 | $0.71 |
States with the most J3010 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 25,520 | $0.71 |
| Kentucky | 23,148 | $0.69 |
| Texas | 18,236 | $0.71 |
| New York | 9,449 | $0.73 |
| Georgia | 8,663 | $0.71 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 700 | Clinical: CMS Workgroup |
| outpatient hospital claims | 100 | Clinical: CMS Workgroup |
| practitioner claims | 100 | Clinical: CMS Workgroup |
What changed for J3010
- 1982-01-01: J3010 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 J3010?
J3010 is the HCPCS Level II code for injection, fentanyl citrate, 0.1 mg. Short descriptor: "Fentanyl citrate injection".
How much does Medicare pay for J3010?
In 2024, the average Medicare payment was $0.71 per service (average allowed $0.90).
Does Medicare cover J3010?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J3010 can be billed per day?
700 on DME suppliers; 100 on outpatient hospital claims; 100 on practitioner claims (NCCI medically unlikely edits).
Related J30 codes
- J3000 — Injection, streptomycin, up to 1 gm
- J3030 — Injection, sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
- J3031 — Injection, fremanezumab-vfrm, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self-administered)
- J3032 — Injection, eptinezumab-jjmr, 1 mg
- J3055 — Injection, talquetamab-tgvs, 0.25 mg
- J3060 — Injection, taliglucerase alfa, 10 units
- J3070 — Injection, pentazocine, 30 mg
- J3090 — Injection, tedizolid phosphate, 1 mg
- J3095 — Injection, telavancin, 10 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 J3010
- Watch J3010 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3010
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.