How much does Medicare pay for HCPCS J3032?

Medicare allowed an average of $17.64 per service and paid $14.05 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $45.56, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code J3032?

Injection, eptinezumab-jjmr, 1 mg. It was billed 947,084 times to 2,036 Medicare beneficiaries by 108 providers in 2024.

Which specialty bills J3032 most?

Nurse Practitioner, with 403,644 services from 57 clinicians. Next are Neurology, Hematology-Oncology, Anesthesiology.

HCPCS J3032

Injection, eptinezumab-jjmr, 1 mg

$17.64Medicare-allowed amount per service, averaged across 947,084 services

Providers submitted

$45.56

Asking price, not received

Medicare allowed

$17.64

The fee schedule figure

Medicare paid

$14.05

Balance is patient coinsurance

Providers submitted an average of $45.56 for this code and Medicare allowed $17.64 — 2.6× 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 $14.05 (80%); the rest is the patient’s coinsurance and deductible.

Services: 947,084
Beneficiaries: 2,036
Providers billing it: 108
Total allowed: $16,706,562

What Medicare pays for HCPCS J3032

Across 947,084 services billed by 108 providers to 2,036 beneficiaries, Medicare allowed an average of $17.64 per service. That is 465.2 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 J3032

Specialty	Services	Beneficiaries	Avg allowed	Providers
Nurse Practitioner	403,644	996	$17.48	57
Neurology	389,036	724	$17.81	35
Hematology-Oncology	43,800	91	$17.48	5
Anesthesiology	26,403	50	$17.96	1
Family Practice	19,000	55	$17.64	2
Gastroenterology	13,300	17	$18.06	1
Orthopedic Surgery	11,100	13	$16.74	1
Allergy/ Immunology	10,600	15	$18.04	1
Infectious Disease	9,600	19	$18.10	1
Rheumatology	7,700	23	$17.71	2
Interventional Pain Management	7,001	16	$18.11	1
Vascular Surgery	5,900	17	$16.13	1

J3032 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	135,505	$17.88	$14.40	11
Florida	115,300	$17.59	$14.47	14
Texas	100,300	$17.73	$14.23	7
Georgia	88,800	$17.77	$14.41	10
New York	51,124	$16.53	$13.58	9
South Carolina	48,100	$17.06	$14.56	6
Oklahoma	46,100	$17.06	$13.85	7
New Jersey	44,339	$18.01	$14.37	4
Colorado	38,703	$17.89	$14.40	2
North Carolina	38,504	$17.65	$14.31	5
Pennsylvania	26,500	$17.50	$13.88	4
Kansas	24,700	$17.85	$14.43	4
Maryland	24,700	$18.06	$14.30	2
Michigan	22,200	$17.91	$14.36	1
Missouri	19,400	$18.06	$14.30	3
Virginia	16,400	$18.09	$14.26	2
Illinois	15,600	$16.79	$14.63	3
Wisconsin	13,300	$18.06	$14.33	1
Delaware	11,000	$18.13	$14.36	1
Massachusetts	10,709	$18.11	$14.34	2
District of Columbia	10,600	$17.92	$14.35	2
Arizona	9,800	$18.14	$14.39	1
Tennessee	8,200	$17.54	$13.89	2
Minnesota	7,800	$18.06	$14.50	2
Mississippi	7,700	$16.25	$14.76	1
Nevada	7,400	$18.20	$14.42	1
Alabama	4,300	$18.05	$14.34	1

Related codes

J3010Injection, fentanyl citrate, 0.1 mg$0.90

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.