J3111 HCPCS code: Injection, romosozumab-aqqg, 1 mg
J3111 is the HCPCS Level II code for injection, romosozumab-aqqg, 1 mg. In 2024 Medicare paid an average of $8.49 per service for J3111 across 39,897,020 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 210 per day on outpatient hospital claims. Medicare volume rose 76% from 2022 to 2024 (22,656,594 to 39,897,020 services). In 2024, about 6,820 clinicians billed Medicare for J3111 for 35,551 beneficiaries; Florida, California, Texas accounted for 33% 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 | O1E — Other drugs |
| Added | 2019-10-01 |
| Last action effective | 2019-10-01 |
Who bills J3111 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 6,820 |
| Medicare beneficiaries | 35,551 |
| States with claims | 51 |
| Share of services in top 3 states (Florida, California, Texas) | 33% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3111, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 22,656,594 | 20,272 | $9.38 | $7.46 |
| 2023 | 31,497,390 | 28,185 | $9.92 | $7.87 |
| 2024 | 39,897,020 | 35,551 | $10.69 | $8.49 |
States with the most J3111 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 4,949,710 | $8.49 |
| California | 4,663,238 | $8.48 |
| Texas | 3,498,976 | $8.50 |
| Pennsylvania | 2,395,899 | $8.52 |
| Illinois | 1,891,494 | $8.53 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 210 | Prescribing Information |
| practitioner claims | 210 | Prescribing Information |
What changed for J3111
- 2019-10-01: J3111 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 J3111?
J3111 is the HCPCS Level II code for injection, romosozumab-aqqg, 1 mg. Short descriptor: "Inj. romosozumab-aqqg 1 mg".
How much does Medicare pay for J3111?
In 2024, the average Medicare payment was $8.49 per service (average allowed $10.69).
Does Medicare cover J3111?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J3111 can be billed per day?
210 on outpatient hospital claims; 210 on practitioner claims (NCCI medically unlikely edits).
Related J31 codes
- J3101 — Injection, tenecteplase, 1 mg
- J3105 — Injection, terbutaline sulfate, up to 1 mg
- J3110 — Injection, teriparatide, 10 mcg
- J3120 — Injection, testosterone enanthate, up to 100 mg
- J3121 — Injection, testosterone enanthate, 1 mg
- J3130 — Injection, testosterone enanthate, up to 200 mg
- J3140 — Injection, testosterone suspension, up to 50 mg
- J3145 — Injection, testosterone undecanoate, 1 mg
- J3150 — Injection, testosterone propionate, up to 100 mg
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Next steps
- Run a reimbursement report for a device billed under J3111
- Watch J3111 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3111
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.