J9155 HCPCS code: Injection, degarelix, 1 mg
J9155 is the HCPCS Level II code for injection, degarelix, 1 mg. In 2024 Medicare paid an average of $3.26 per service for J9155 across 2,340,292 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 240 per day on outpatient hospital claims. Medicare volume fell 25% from 2022 to 2024 (3,111,231 to 2,340,292 services). In 2024, about 2,815 clinicians billed Medicare for J9155 for 6,517 beneficiaries; Florida, California, Maryland accounted for 25% 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 | 2010-01-01 |
| Last action effective | 2010-01-01 |
Who bills J9155 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 2,815 |
| Medicare beneficiaries | 6,517 |
| States with claims | 44 |
| Share of services in top 3 states (Florida, California, Maryland) | 25% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J9155, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 3,111,231 | 8,468 | $3.97 | $3.12 |
| 2023 | 2,820,045 | 7,765 | $4.03 | $3.17 |
| 2024 | 2,340,292 | 6,517 | $4.15 | $3.26 |
States with the most J9155 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 275,062 | $3.28 |
| California | 166,508 | $3.24 |
| Maryland | 150,042 | $3.26 |
| New Jersey | 119,147 | $3.29 |
| Virginia | 111,047 | $3.25 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 240 | Prescribing Information |
| practitioner claims | 240 | Prescribing Information |
What changed for J9155
- 2010-01-01: J9155 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 J9155?
J9155 is the HCPCS Level II code for injection, degarelix, 1 mg. Short descriptor: "Degarelix injection".
How much does Medicare pay for J9155?
In 2024, the average Medicare payment was $3.26 per service (average allowed $4.15).
Does Medicare cover J9155?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J9155 can be billed per day?
240 on outpatient hospital claims; 240 on practitioner claims (NCCI medically unlikely edits).
Related J91 codes
- J9100 — Injection, cytarabine, 100 mg
- J9118 — Injection, calaspargase pegol-mknl, 10 units
- J9119 — Injection, cemiplimab-rwlc, 1 mg
- J9120 — Injection, dactinomycin, 0.5 mg
- J9130 — Dacarbazine, 100 mg
- J9144 — Injection, daratumumab, 10 mg and hyaluronidase-fihj
- J9145 — Injection, daratumumab, 10 mg
- J9150 — Injection, daunorubicin, 10 mg
- J9151 — Injection, daunorubicin citrate, liposomal formulation, 10 mg
- J9153 — Injection, liposomal, 1 mg daunorubicin and 2.27 mg cytarabine
- J9160 — Injection, denileukin diftitox, 300 micrograms
- J9161 — Injection, denileukin diftitox-cxdl, 1 mcg
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Next steps
- Run a reimbursement report for a device billed under J9155
- Watch J9155 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J9155
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.