J7351 HCPCS code: Injection, bimatoprost, intracameral implant, 1 microgram
J7351 is the HCPCS Level II code for injection, bimatoprost, intracameral implant, 1 microgram. In 2024 Medicare paid an average of $161.56 per service for J7351 across 101,954 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 20 per day on outpatient hospital claims. In 2024, about 1,168 clinicians billed Medicare for J7351 for 6,327 beneficiaries; California, Florida, Texas accounted for 39% 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 J7351 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 1,168 |
| Medicare beneficiaries | 6,327 |
| States with claims | 44 |
| Share of services in top 3 states (California, Florida, Texas) | 39% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7351, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 102,456 | 6,377 | $202.15 | $161.08 |
| 2023 | 107,018 | 6,583 | $201.56 | $160.42 |
| 2024 | 101,954 | 6,327 | $203.06 | $161.56 |
States with the most J7351 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 16,829 | $162.14 |
| Florida | 13,926 | $160.32 |
| Texas | 8,267 | $161.99 |
| Massachusetts | 5,962 | $161.92 |
| Pennsylvania | 4,738 | $162.11 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 20 | Anatomic Consideration |
| practitioner claims | 20 | Anatomic Consideration |
What changed for J7351
- 2020-10-01: J7351 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 J7351?
J7351 is the HCPCS Level II code for injection, bimatoprost, intracameral implant, 1 microgram. Short descriptor: "Inj bimatoprost itc imp1mcg".
How much does Medicare pay for J7351?
In 2024, the average Medicare payment was $161.56 per service (average allowed $203.06).
Does Medicare cover J7351?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J7351 can be billed per day?
20 on outpatient hospital claims; 20 on practitioner claims (NCCI medically unlikely edits).
Related J73 codes
- J7300 — Intrauterine copper contraceptive (paragard)
- J7301 — Levonorgestrel-releasing intrauterine contraceptive system (skyla), 13.5 mg
- J7302 — Levonorgestrel-releasing intrauterine contraceptive system, 52 mg
- J7303 — Contraceptive supply, hormone containing vaginal ring, each
- J7304 — Contraceptive supply, hormone containing patch, each
- J7306 — Levonorgestrel (contraceptive) implant system, including implants and supplies
- J7307 — Etonogestrel (contraceptive) implant system, including implant and supplies
- J7308 — Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)
- J7309 — Methyl aminolevulinate (mal) for topical administration, 16.8%, 1 gram
- J7310 — Ganciclovir, 4.5 mg, long-acting implant
- J7311 — Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg
- J7312 — Injection, dexamethasone, intravitreal implant, 0.1 mg
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 J7351
- Watch J7351 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7351
Sources: CMS HCPCS Level II release October 2026; 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.