J3489 HCPCS code: Injection, zoledronic acid, 1 mg
J3489 is the HCPCS Level II code for injection, zoledronic acid, 1 mg. In 2024 Medicare paid an average of $4.70 per service for J3489 across 648,414 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 5 per day on outpatient hospital claims. Medicare volume rose 9% from 2022 to 2024 (595,766 to 648,414 services). In 2024, about 9,698 clinicians billed Medicare for J3489 for 97,189 beneficiaries; Texas, Florida, California accounted for 31% 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 | 2014-01-01 |
| Last action effective | 2018-01-01 |
Who bills J3489 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 9,698 |
| Medicare beneficiaries | 97,189 |
| States with claims | 54 |
| Share of services in top 3 states (Texas, Florida, California) | 31% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3489, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 595,766 | 83,589 | $7.16 | $5.36 |
| 2023 | 619,107 | 90,677 | $8.58 | $6.28 |
| 2024 | 648,414 | 97,189 | $6.45 | $4.70 |
States with the most J3489 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 73,503 | $4.74 |
| Florida | 65,568 | $4.86 |
| California | 63,811 | $4.69 |
| Illinois | 31,212 | $4.77 |
| Maryland | 27,525 | $4.73 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 5 | Prescribing Information |
| practitioner claims | 5 | Prescribing Information |
Medicare policy articles for this code
- A56907: Billing and Coding: Bisphosphonate Drug Therapy (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
Covered diagnoses (228 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C50.011 | Malignant neoplasm of nipple and areola, right female breast | 1 |
| C50.012 | Malignant neoplasm of nipple and areola, left female breast | 1 |
| C50.021 | Malignant neoplasm of nipple and areola, right male breast | 1 |
| C50.022 | Malignant neoplasm of nipple and areola, left male breast | 1 |
| C50.111 | Malignant neoplasm of central portion of right female breast | 1 |
| C50.112 | Malignant neoplasm of central portion of left female breast | 1 |
| C50.121 | Malignant neoplasm of central portion of right male breast | 1 |
| C50.122 | Malignant neoplasm of central portion of left male breast | 1 |
| C50.211 | Malignant neoplasm of upper-inner quadrant of right female breast | 1 |
| C50.212 | Malignant neoplasm of upper-inner quadrant of left female breast | 1 |
Showing 10 of 228. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J3489
- 2014-01-01: J3489 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 J3489?
J3489 is the HCPCS Level II code for injection, zoledronic acid, 1 mg. Short descriptor: "Zoledronic acid 1mg".
How much does Medicare pay for J3489?
In 2024, the average Medicare payment was $4.70 per service (average allowed $6.45).
Does Medicare cover J3489?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J3489?
Medicare policy articles that cite J3489 list 228 covered ICD-10-CM diagnosis codes across 1 article. The most cited include C50.011 (Malignant neoplasm of nipple and areola, right female breast), C50.012 (Malignant neoplasm of nipple and areola, left female breast), C50.021 (Malignant neoplasm of nipple and areola, right male breast). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J3489 can be billed per day?
5 on outpatient hospital claims; 5 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 J3489
- Watch J3489 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3489
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.