RxDoctor Payments Data

HCPCS J0153

Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)

$0.50Medicare-allowed amount per service, averaged across 486,020 services
Providers submitted
$5.65

Asking price, not received

Medicare allowed
$0.50

The fee schedule figure

Medicare paid
$0.39

Balance is patient coinsurance

Providers submitted an average of $5.65 for this code and Medicare allowed $0.5011.3× 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 $0.39 (78%); the rest is the patient’s coinsurance and deductible.

Services
486,020

Medicare Part B, 2024

Beneficiaries
9,848
Providers billing it
175
Total allowed
$243,010

Services × allowed amount

What Medicare pays for HCPCS J0153

Across 486,020 services billed by 175 providers to 9,848 beneficiaries, Medicare allowed an average of $0.50 per service. That is 49.4 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 J0153

SpecialtyServicesBeneficiariesAvg allowedProviders
Cardiology381,3818,027$0.50126
Internal Medicine37,212579$0.5015
Interventional Cardiology30,723597$0.5120
Independent Diagnostic Testing Facility (IDTF)13,530210$0.493
Nuclear Medicine8,510215$0.464
Family Practice7,62086$0.483
Nurse Practitioner4,09069$0.461
Clinical Cardiac Electrophysiology2,17347$0.482
Cardiac Surgery78118$0.561

J0153 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
California138,460$0.50$0.4044
Florida123,180$0.51$0.4151
New York48,553$0.49$0.3913
Texas25,714$0.49$0.3911
Oklahoma24,010$0.49$0.402
North Carolina19,023$0.47$0.366
Pennsylvania15,167$0.45$0.354
Michigan15,045$0.49$0.393
Tennessee12,262$0.48$0.391
New Jersey11,441$0.54$0.409
Puerto Rico9,042$0.46$0.374
Kansas8,793$0.49$0.393
Ohio7,108$0.48$0.391
Wisconsin5,830$0.51$0.385
Alabama5,671$0.50$0.402
Maryland4,171$0.47$0.381
Louisiana4,149$0.48$0.382
South Carolina2,805$0.51$0.413
Arizona2,520$0.50$0.401
Alaska1,679$0.54$0.432
Delaware778$0.57$0.461
Connecticut367$0.59$0.471
Georgia167$0.50$0.413
Virginia84$0.46$0.362

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.