How much does Medicare pay for HCPCS J0881?

Medicare allowed an average of $2.92 per service and paid $2.31 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $14.69, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code J0881?

Injection, darbepoetin alfa, 1 microgram (non-esrd use). It was billed 20,179,038 times to 27,420 Medicare beneficiaries by 1,179 providers in 2024.

Which specialty bills J0881 most?

Hematology-Oncology, with 13,982,287 services from 718 clinicians. Next are Medical Oncology, Internal Medicine, Nephrology.

HCPCS J0881

Injection, darbepoetin alfa, 1 microgram (non-esrd use)

$2.92Medicare-allowed amount per service, averaged across 20,179,038 services

Providers submitted

$14.69

Asking price, not received

Medicare allowed

$2.92

The fee schedule figure

Medicare paid

$2.31

Balance is patient coinsurance

Providers submitted an average of $14.69 for this code and Medicare allowed $2.92 — 5.0× 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 $2.31 (79%); the rest is the patient’s coinsurance and deductible.

Services: 20,179,038
Beneficiaries: 27,420
Providers billing it: 1,179
Total allowed: $58,922,791

What Medicare pays for HCPCS J0881

Across 20,179,038 services billed by 1,179 providers to 27,420 beneficiaries, Medicare allowed an average of $2.92 per service. That is 735.9 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 J0881

Specialty	Services	Beneficiaries	Avg allowed	Providers
Hematology-Oncology	13,982,287	17,472	$2.92	718
Medical Oncology	3,442,335	4,637	$2.91	214
Internal Medicine	821,125	1,241	$2.93	48
Nephrology	642,440	2,096	$2.92	107
Hematology	537,606	596	$2.93	20
Nurse Practitioner	494,763	969	$2.92	48
Physician Assistant	145,072	210	$2.90	11
Hospitalist	48,540	62	$2.90	3
Gynecological Oncology	37,430	41	$2.92	3
Hematopoietic Cell Transplantation and Cellular Therapy	12,765	33	$2.91	2
Radiation Oncology	9,555	38	$2.92	3
Obstetrics & Gynecology	2,905	14	$2.95	1
Family Practice	2,215	11	$2.90	1

J0881 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.

State	Services	Allowed	Standardized pmt	Providers
California	2,821,135	$2.93	$2.32	98
Maryland	2,229,291	$2.93	$2.32	66
Texas	1,793,701	$2.92	$2.31	172
Tennessee	1,558,491	$2.93	$2.31	79
New York	1,242,600	$2.90	$2.31	75
Pennsylvania	1,207,809	$2.93	$2.32	46
Virginia	1,083,438	$2.93	$2.32	76
Florida	1,066,950	$2.93	$2.32	68
Illinois	958,054	$2.93	$2.32	74
New Jersey	821,916	$2.94	$2.34	48
Arizona	552,903	$2.94	$2.33	58
Nevada	521,343	$2.93	$2.32	26
Nebraska	414,185	$2.94	$2.32	21
Georgia	407,235	$2.89	$2.29	20
Kansas	387,016	$2.93	$2.31	13
Missouri	306,695	$2.94	$2.31	8
Ohio	288,455	$2.62	$2.07	15
Alabama	284,451	$2.94	$2.32	24
North Carolina	262,585	$2.93	$2.33	28
Arkansas	254,651	$2.94	$2.34	8
Iowa	175,040	$2.94	$2.30	11
Minnesota	168,195	$2.92	$2.32	16
South Carolina	161,760	$2.93	$2.32	13
Oregon	159,260	$2.93	$2.33	13
Indiana	142,681	$2.92	$2.31	11
Washington	132,555	$2.92	$2.30	21
Maine	106,820	$2.91	$2.33	5
Colorado	106,778	$2.93	$2.31	11
Delaware	92,395	$2.90	$2.32	3
Michigan	92,145	$2.94	$2.30	18
Connecticut	80,135	$2.93	$2.34	8
Vermont	72,700	$2.95	$2.35	1
New Mexico	53,340	$2.93	$2.33	3
Massachusetts	41,765	$2.93	$2.30	3
North Dakota	34,580	$2.93	$2.32	2
Mississippi	27,340	$2.91	$2.31	2
Oklahoma	17,940	$2.94	$2.32	5
Guam	17,300	$2.94	$2.33	1
Montana	9,320	$2.95	$2.34	1
Wisconsin	7,680	$2.94	$2.28	1
West Virginia	5,630	$2.93	$2.28	1
South Dakota	4,880	$2.94	$2.34	1
Louisiana	3,220	$2.88	$2.20	4
Kentucky	2,675	$2.96	$2.36	1

Related codes

J0897Injection, denosumab, 1 mg$25.41
J0878Injection, daptomycin, 1 mg$0.05
J0885Injection, epoetin alfa, (for non-esrd use), 1000 units$8.01
J0872Injection, daptomycin (xellia), unrefrigerated, not therapeutically eq$0.23
J0875Injection, dalbavancin, 5 mg$15.07
J0896Injection, luspatercept-aamt, 0.25 mg$39.63
J0894Injection, decitabine, 1 mg$1.57

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.