RxDoctor Payments Data

HCPCS J1952

Leuprolide injectable, camcevi, 1 mg

$56.44Medicare-allowed amount per service, averaged across 368,147 services
Providers submitted
$172.94

Asking price, not received

Medicare allowed
$56.44

The fee schedule figure

Medicare paid
$44.83

Balance is patient coinsurance

Providers submitted an average of $172.94 for this code and Medicare allowed $56.443.1× 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 $44.83 (79%); the rest is the patient’s coinsurance and deductible.

Services
368,147

Medicare Part B, 2024

Beneficiaries
6,743
Providers billing it
295
Total allowed
$20,778,217

Services × allowed amount

What Medicare pays for HCPCS J1952

Across 368,147 services billed by 295 providers to 6,743 beneficiaries, Medicare allowed an average of $56.44 per service. That is 54.6 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 J1952

SpecialtyServicesBeneficiariesAvg allowedProviders
Urology331,5646,011$56.42265
Nurse Practitioner15,289310$56.2110
Physician Assistant12,264251$57.078
Hematology-Oncology6,930129$57.149
Medical Oncology1,47030$57.082
Internal Medicine63012$55.971

J1952 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
Illinois42,306$56.47$45.2232
California39,417$56.25$45.1528
Virginia37,464$56.02$44.9725
New York30,408$56.84$45.3828
Indiana29,066$56.27$44.8525
Texas19,027$56.32$45.0719
Missouri16,380$56.45$44.9110
Ohio13,230$56.39$45.307
Pennsylvania12,726$56.03$45.266
Florida12,643$56.98$45.2713
Michigan11,340$56.69$45.064
Nebraska11,130$56.66$45.439
Massachusetts11,053$55.84$45.0910
Arizona10,500$56.65$44.9711
Tennessee9,001$56.74$45.328
Louisiana7,854$57.09$45.349
North Carolina7,056$56.39$45.497
Maryland6,132$56.92$45.153
Georgia5,839$56.02$45.097
Arkansas5,796$56.97$46.233
Kansas4,788$56.94$45.207
Kentucky4,662$56.54$45.133
South Carolina4,494$57.16$45.605
Oklahoma4,200$56.19$45.624
Iowa3,655$55.91$44.514
Colorado3,276$56.91$45.142
Oregon1,470$56.99$45.381
Idaho1,386$56.52$45.032
New Jersey714$55.60$44.301
Wyoming588$57.59$45.521
Delaware546$57.44$45.651

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.