J3420 HCPCS code: Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
J3420 is the HCPCS Level II code for injection, vitamin b-12 cyanocobalamin, up to 1000 mcg. In 2024 Medicare paid an average of $0.88 per service for J3420 across 1,551,772 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 1 per day on outpatient hospital claims. Medicare volume fell 10% from 2022 to 2024 (1,733,001 to 1,551,772 services). In 2024, about 82,680 clinicians billed Medicare for J3420 for 367,676 beneficiaries; Florida, California, New York accounted for 31% 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 | 1986-01-01 |
| Last action effective | 1997-01-01 |
Who bills J3420 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 82,680 |
| Medicare beneficiaries | 367,676 |
| States with claims | 55 |
| Share of services in top 3 states (Florida, California, New York) | 31% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3420, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,733,001 | 412,397 | $1.68 | $1.20 |
| 2023 | 1,644,841 | 393,366 | $1.52 | $1.07 |
| 2024 | 1,551,772 | 367,676 | $1.24 | $0.88 |
States with the most J3420 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 191,438 | $0.92 |
| California | 189,507 | $0.91 |
| New York | 102,088 | $0.91 |
| North Carolina | 64,856 | $0.83 |
| Tennessee | 62,236 | $0.86 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 1 | Prescribing Information |
| practitioner claims | 1 | Prescribing Information |
Medicare policy articles for this code
- A57755: Billing and Coding: Vitamin B12 Injections (First Coast Service Options, Inc. (MAC - Part B))
Covered diagnoses (44 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| D51.0 | Vitamin B12 deficiency anemia due to intrinsic factor deficiency | 1 |
| D51.1 | Vitamin B12 deficiency anemia due to selective vitamin B12 malabsorption with proteinuria | 1 |
| D51.2 | Transcobalamin II deficiency | 1 |
| D51.3 | Other dietary vitamin B12 deficiency anemia | 1 |
| D51.8 | Other vitamin B12 deficiency anemias | 1 |
| D51.9 | Vitamin B12 deficiency anemia, unspecified | 1 |
| D52.0 | Dietary folate deficiency anemia | 1 |
| D52.1 | Drug-induced folate deficiency anemia | 1 |
| D52.8 | Other folate deficiency anemias | 1 |
| D52.9 | Folate deficiency anemia, unspecified | 1 |
Showing 10 of 44. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J3420
- 1986-01-01: J3420 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 J3420?
J3420 is the HCPCS Level II code for injection, vitamin b-12 cyanocobalamin, up to 1000 mcg. Short descriptor: "Vitamin b12 injection".
How much does Medicare pay for J3420?
In 2024, the average Medicare payment was $0.88 per service (average allowed $1.24).
Does Medicare cover J3420?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J3420?
Medicare policy articles that cite J3420 list 44 covered ICD-10-CM diagnosis codes across 1 article. The most cited include D51.0 (Vitamin B12 deficiency anemia due to intrinsic factor deficiency), D51.1 (Vitamin B12 deficiency anemia due to selective vitamin B12 malabsorption with proteinuria), D51.2 (Transcobalamin II deficiency). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J3420 can be billed per day?
1 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related J34 codes
- J3400 — Injection, triflupromazine hcl, up to 20 mg
- J3401 — Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml
- J3402 — Injection, remestemcel-l-rknd, per therapeutic dose
- J3403 — Revakinagene taroretcel-lwey, per implant
- J3410 — Injection, hydroxyzine hcl, up to 25 mg
- J3411 — Injection, thiamine hcl, 100 mg
- J3415 — Injection, pyridoxine hcl, 100 mg
- J3424 — Injection, hydroxocobalamin, intravenous, 25 mg
- J3425 — Injection, hydroxocobalamin, intramuscular, 10 mcg
- J3430 — Injection, phytonadione (vitamin k), per 1 mg
- J3465 — Injection, voriconazole, 10 mg
- J3470 — Injection, hyaluronidase, up to 150 units
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Next steps
- Run a reimbursement report for a device billed under J3420
- Watch J3420 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3420
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.