J3241 HCPCS code: Injection, teprotumumab-trbw, 10 mg
J3241 is the HCPCS Level II code for injection, teprotumumab-trbw, 10 mg. In 2024 Medicare paid an average of $253.58 per service for J3241 across 579,432 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 500 per day on DME suppliers. Medicare volume fell 14% from 2022 to 2024 (675,934 to 579,432 services). In 2024, about 637 clinicians billed Medicare for J3241 for 726 beneficiaries; Florida, California, Texas accounted for 32% 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 | 2020-10-01 |
| Last action effective | 2020-10-01 |
Who bills J3241 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 637 |
| Medicare beneficiaries | 726 |
| States with claims | 27 |
| Share of services in top 3 states (Florida, California, Texas) | 32% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3241, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 675,934 | 832 | $312.65 | $249.55 |
| 2023 | 620,409 | 757 | $313.88 | $250.06 |
| 2024 | 579,432 | 726 | $318.31 | $253.58 |
States with the most J3241 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 68,417 | $262.40 |
| California | 58,912 | $252.80 |
| Texas | 40,898 | $253.12 |
| New York | 32,207 | $236.79 |
| Tennessee | 27,314 | $238.39 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 500 | Prescribing Information |
| outpatient hospital claims | 500 | Prescribing Information |
| practitioner claims | 500 | Prescribing Information |
What changed for J3241
- 2020-10-01: J3241 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 J3241?
J3241 is the HCPCS Level II code for injection, teprotumumab-trbw, 10 mg. Short descriptor: "Inj. teprotumumab-trbw 10 mg".
How much does Medicare pay for J3241?
In 2024, the average Medicare payment was $253.58 per service (average allowed $318.31).
Does Medicare cover J3241?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J3241 can be billed per day?
500 on DME suppliers; 500 on outpatient hospital claims; 500 on practitioner claims (NCCI medically unlikely edits).
Related J32 codes
- J3230 — Injection, chlorpromazine hcl, up to 50 mg
- J3240 — Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial
- J3243 — Injection, tigecycline, 1 mg
- J3244 — Injection, tigecycline (accord), not therapeutically equivalent to j3243, 1 mg
- J3245 — Injection, tildrakizumab, 1 mg
- J3246 — Injection, tirofiban hcl, 0.25 mg
- J3247 — Injection, secukinumab, intravenous, 1 mg
- J3250 — Injection, trimethobenzamide hcl, up to 200 mg
- J3260 — Injection, tobramycin sulfate, up to 80 mg
- J3262 — Injection, tocilizumab, 1 mg
- J3263 — Injection, toripalimab-tpzi, 1 mg
- J3265 — Injection, torsemide, 10 mg/ml
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 J3241
- Watch J3241 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3241
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.