RxDoctor Payments Data

HCPCS J1885

Injection, ketorolac tromethamine, per 15 mg

$0.65Medicare-allowed amount per service, averaged across 930,781 services
Providers submitted
$14.01

Asking price, not received

Medicare allowed
$0.65

The fee schedule figure

Medicare paid
$0.49

Balance is patient coinsurance

Providers submitted an average of $14.01 for this code and Medicare allowed $0.6521.6× 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 $0.49 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$0.65
Hospital / facility
$0.67

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 930,340 services were billed in an office setting and 441 in a facility.

Services
930,781

Medicare Part B, 2024

Beneficiaries
213,169
Providers billing it
7,319
Total allowed
$605,008

Services × allowed amount

What Medicare pays for HCPCS J1885

Across 930,781 services billed by 7,319 providers to 213,169 beneficiaries, Medicare allowed an average of $0.65 per service. That is 4.4 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 J1885

SpecialtyServicesBeneficiariesAvg allowedProviders
Family Practice190,82542,121$0.651,554
Nurse Practitioner184,49047,689$0.662,093
Internal Medicine121,72424,962$0.66885
Physician Assistant96,67424,971$0.66923
Orthopedic Surgery76,44020,324$0.66431
Pain Management46,7038,499$0.66183
Physical Medicine and Rehabilitation39,3187,245$0.66185
Rheumatology31,8805,716$0.65126
Interventional Pain Management27,7716,009$0.65145
Anesthesiology22,4994,723$0.65132
General Practice22,1233,794$0.6697
Emergency Medicine20,6777,110$0.66255
Neurology13,5992,464$0.6468
Obstetrics & Gynecology6,715490$0.668
Hematology-Oncology5,207316$0.6113

J1885 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
California152,192$0.66$0.50942
Florida95,772$0.66$0.51612
Texas83,265$0.66$0.50731
Mississippi67,346$0.66$0.49491
Alabama65,720$0.64$0.49534
Georgia52,569$0.66$0.49501
Tennessee46,001$0.66$0.50436
Louisiana38,142$0.66$0.49347
New York37,006$0.66$0.52171
North Carolina32,906$0.66$0.50281
Michigan30,310$0.65$0.49282
Virginia23,767$0.65$0.50149
Oklahoma22,814$0.65$0.48174
South Carolina20,593$0.65$0.49182
Arizona17,390$0.64$0.49163
Arkansas16,433$0.65$0.47171
Nevada15,108$0.65$0.5090
Kentucky11,051$0.65$0.49115
Ohio10,430$0.66$0.4989
New Jersey10,407$0.67$0.5197
Illinois9,278$0.67$0.5178
Maryland9,022$0.66$0.5070
Indiana8,591$0.66$0.5069
Pennsylvania7,055$0.66$0.5154
New Mexico4,901$0.65$0.4844
Wisconsin4,474$0.66$0.5213
Nebraska4,225$0.65$0.4825
West Virginia4,174$0.66$0.4746
Missouri3,395$0.67$0.5048
Delaware3,131$0.68$0.5218
Utah3,008$0.66$0.4729
Colorado2,439$0.67$0.5129
Kansas2,021$0.66$0.4928
Massachusetts1,987$0.66$0.5030
Iowa1,950$0.65$0.4627
Washington1,853$0.64$0.5028
Oregon1,157$0.66$0.4923
Connecticut1,099$0.68$0.539
Alaska1,045$0.66$0.4913
Minnesota970$0.66$0.5010
Hawaii926$0.65$0.517
South Dakota899$0.61$0.4413
Idaho836$0.68$0.5012
Puerto Rico648$0.62$0.414
Rhode Island490$0.64$0.513
Wyoming422$0.67$0.457
Montana391$0.63$0.477
U.S. Virgin Islands388$0.60$0.424
ZZ222$0.65$0.482
District of Columbia202$0.67$0.523
New Hampshire161$0.69$0.553
North Dakota106$0.67$0.532
Vermont65$0.66$0.422
Maine30$0.62$0.451

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.