J3473 HCPCS code: Injection, hyaluronidase, recombinant, 1 usp unit
J3473 is the HCPCS Level II code for injection, hyaluronidase, recombinant, 1 usp unit. In 2024 Medicare paid an average of $0.24 per service for J3473 across 151,437 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 450 per day on outpatient hospital claims. Medicare volume rose 49% from 2022 to 2024 (101,872 to 151,437 services). In 2024, about 74 clinicians billed Medicare for J3473 for 364 beneficiaries; Maryland, New York, Texas accounted for 95% 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 | 2007-01-01 |
| Last action effective | 2007-01-01 |
Who bills J3473 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 74 |
| Medicare beneficiaries | 364 |
| States with claims | 7 |
| Share of services in top 3 states (Maryland, New York, Texas) | 95% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3473, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 101,872 | 294 | $0.36 | $0.28 |
| 2023 | 118,692 | 387 | $0.33 | $0.27 |
| 2024 | 151,437 | 364 | $0.31 | $0.24 |
States with the most J3473 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Maryland | 90,150 | $0.22 |
| New York | 28,050 | $0.27 |
| Texas | 20,003 | $0.28 |
| Illinois | 3,008 | $0.27 |
| Alabama | 2,315 | $0.28 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 450 | Prescribing Information |
| practitioner claims | 450 | Prescribing Information |
What changed for J3473
- 2007-01-01: J3473 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 J3473?
J3473 is the HCPCS Level II code for injection, hyaluronidase, recombinant, 1 usp unit. Short descriptor: "Hyaluronidase recombinant".
How much does Medicare pay for J3473?
In 2024, the average Medicare payment was $0.24 per service (average allowed $0.31).
Does Medicare cover J3473?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J3473 can be billed per day?
450 on outpatient hospital claims; 450 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
- J3420 — Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg
- 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
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Next steps
- Run a reimbursement report for a device billed under J3473
- Watch J3473 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3473
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.