RxDoctor Payments Data

HCPCS J2353

Injection, octreotide, depot form for intramuscular injection, 1 mg

$207.19Medicare-allowed amount per service, averaged across 17,060 services
Providers submitted
$562.90

Asking price, not received

Medicare allowed
$207.19

The fee schedule figure

Medicare paid
$164.98

Balance is patient coinsurance

Providers submitted an average of $562.90 for this code and Medicare allowed $207.192.7× 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 $164.98 (80%); the rest is the patient’s coinsurance and deductible.

Services
17,060

Medicare Part B, 2024

Beneficiaries
183
Providers billing it
14
Total allowed
$3,534,661

Services × allowed amount

What Medicare pays for HCPCS J2353

Across 17,060 services billed by 14 providers to 183 beneficiaries, Medicare allowed an average of $207.19 per service. That is 93.2 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 J2353

SpecialtyServicesBeneficiariesAvg allowedProviders
Hematology-Oncology13,020141$206.8311
Medical Oncology2,81031$208.362
Internal Medicine1,23011$208.301

J2353 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
Illinois6,460$206.44$167.805
Arkansas2,560$204.91$163.231
Missouri1,800$207.33$165.151
Wisconsin1,740$207.88$167.091
Florida1,700$208.91$166.252
Arizona1,420$210.20$167.442
New York920$208.75$166.321
Tennessee460$208.35$166.001

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.