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HCPCS J0129

Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)

$42.28Medicare-allowed amount per service, averaged across 13,105,162 services
Providers submitted
$90.76

Asking price, not received

Medicare allowed
$42.28

The fee schedule figure

Medicare paid
$33.60

Balance is patient coinsurance

Providers submitted an average of $90.76 for this code and Medicare allowed $42.28 — 2.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $33.60 (79%); the rest is the patient’s coinsurance and deductible.

Services
13,105,162

Medicare Part B, 2024

Beneficiaries
33,754
Providers billing it
1,247
Total allowed
$554,086,249

Services × allowed amount

What Medicare pays for HCPCS J0129

Across 13,105,162 services billed by 1,247 providers to 33,754 beneficiaries, Medicare allowed an average of $42.28 per service. That is 388.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills J0129

SpecialtyServicesBeneficiariesAvg allowedProviders
Rheumatology11,272,64827,643$42.28966
Internal Medicine686,5551,766$42.2365
Nurse Practitioner588,6192,306$42.29113
Physician Assistant144,676669$42.2033
Hematology-Oncology144,050514$42.3028
Family Practice57,975309$42.4015
Allergy/ Immunology50,525151$42.549
Infectious Disease46,675126$42.466
Hospitalist37,22598$42.622
Pediatric Medicine27,12640$42.202
Gastroenterology23,85037$42.601
Neurology6,62511$42.551
Vascular Surgery4,77518$42.821
Endocrinology3,50014$40.311
Medical Oncology3,45012$42.681

J0129 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
Florida1,511,159$42.16$33.74136
Texas1,306,877$42.27$33.90108
North Carolina796,488$42.35$33.8770
California774,261$42.11$33.5576
Pennsylvania614,838$42.53$33.8764
South Carolina574,111$42.12$33.9540
Arizona458,965$42.42$33.8732
Maryland402,482$42.10$33.8544
Virginia394,177$42.51$33.8732
Kentucky370,127$42.17$33.9233
Illinois352,905$42.36$33.9246
New Jersey348,494$42.31$33.9233
New York339,205$42.45$33.9137
Georgia330,624$42.38$33.8925
Oklahoma326,411$42.26$33.9331
Tennessee317,625$42.36$33.9029
Ohio316,579$42.36$33.9133
Missouri313,902$42.32$33.8224
Alabama301,704$42.20$33.9526
Indiana277,079$42.21$33.8426
Colorado257,549$42.36$33.9034
Arkansas238,570$42.32$33.8514
Michigan195,027$42.16$33.9726
Minnesota182,700$42.52$33.8534
Louisiana176,005$42.07$33.9611
Oregon170,560$42.11$33.8822
Washington158,076$42.19$33.8723
Delaware140,851$41.83$34.0510
Wisconsin132,263$42.30$33.9116
Kansas124,125$42.60$33.8115
Iowa116,825$42.60$33.8317
Mississippi110,950$42.48$33.929
Massachusetts104,602$42.41$33.7712
Idaho98,700$42.44$33.898
New Mexico95,277$42.01$33.6110
Nebraska61,875$42.47$33.925
Utah47,040$41.86$33.266
Connecticut41,400$42.53$33.796
Hawaii36,275$42.13$33.911
Montana28,550$42.61$33.853
Nevada24,802$42.39$33.832
Maine21,127$42.56$34.023
West Virginia19,850$41.38$34.232
New Hampshire19,450$42.45$33.932
District of Columbia17,075$42.59$33.813
Puerto Rico12,525$42.43$33.672
Rhode Island12,100$42.55$33.831
South Dakota10,300$42.63$33.892
Alaska8,000$42.59$33.901
North Dakota7,575$42.61$33.861
Wyoming7,125$42.69$33.961

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.