J3243 HCPCS code: Injection, tigecycline, 1 mg
J3243 is the HCPCS Level II code for injection, tigecycline, 1 mg. In 2024 Medicare paid an average of $0.46 per service for J3243 across 68,167 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 150 per day on DME suppliers. Medicare volume fell 16% from 2022 to 2024 (81,477 to 68,167 services). In 2024, about 45 clinicians billed Medicare for J3243 for 42 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 | O1E — Other drugs |
| Added | 2007-01-01 |
| Last action effective | 2022-01-01 |
Who bills J3243 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 45 |
| Medicare beneficiaries | 42 |
| States with claims | 2 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3243, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 81,477 | 51 | $0.99 | $0.79 |
| 2023 | 74,306 | 49 | $0.66 | $0.52 |
| 2024 | 68,167 | 42 | $0.58 | $0.46 |
States with the most J3243 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 36,340 | $0.44 |
| Florida | 13,375 | $0.54 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 150 | Prescribing Information |
| outpatient hospital claims | 200 | Prescribing Information |
| practitioner claims | 150 | Prescribing Information |
What changed for J3243
- 2007-01-01: J3243 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 J3243?
J3243 is the HCPCS Level II code for injection, tigecycline, 1 mg. Short descriptor: "Tigecycline injection".
How much does Medicare pay for J3243?
In 2024, the average Medicare payment was $0.46 per service (average allowed $0.58).
Does Medicare cover J3243?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J3243 can be billed per day?
150 on DME suppliers; 200 on outpatient hospital claims; 150 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
- J3241 — Injection, teprotumumab-trbw, 10 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 J3243
- Watch J3243 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3243
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.