RxDoctor Payments Data

HCPCS J3111

Injection, romosozumab-aqqg, 1 mg

$10.70Medicare-allowed amount per service, averaged across 28,416,634 services
Providers submitted
$22.38

Asking price, not received

Medicare allowed
$10.70

The fee schedule figure

Medicare paid
$8.50

Balance is patient coinsurance

Providers submitted an average of $22.38 for this code and Medicare allowed $10.702.1× 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 $8.50 (79%); the rest is the patient’s coinsurance and deductible.

Services
28,416,634

Medicare Part B, 2024

Beneficiaries
36,482
Providers billing it
1,339
Total allowed
$304,057,984

Services × allowed amount

What Medicare pays for HCPCS J3111

Across 28,416,634 services billed by 1,339 providers to 36,482 beneficiaries, Medicare allowed an average of $10.70 per service. That is 778.9 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 J3111

SpecialtyServicesBeneficiariesAvg allowedProviders
Rheumatology12,434,53915,412$10.68568
Nurse Practitioner6,888,6909,897$10.74315
Endocrinology2,482,3642,616$10.69127
Internal Medicine1,727,8922,150$10.6777
Physician Assistant1,240,1771,637$10.7168
Family Practice766,9361,039$10.7031
Hematology-Oncology646,288861$10.7239
Orthopedic Surgery404,252565$10.6222
Obstetrics & Gynecology325,501298$10.753
Infectious Disease195,300255$10.7314
Gastroenterology180,390182$10.764
General Practice127,324169$10.675
Sports Medicine120,330124$10.743
Anesthesiology113,40097$10.771
Physical Medicine and Rehabilitation104,370101$10.783

J3111 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
Florida3,852,088$10.69$8.48169
California3,396,586$10.71$8.48152
Texas2,523,396$10.71$8.52124
Pennsylvania1,907,750$10.75$8.5083
Illinois1,404,358$10.73$8.5148
Arizona1,173,976$10.29$8.4252
Maryland1,084,502$10.70$8.5041
South Carolina959,926$10.75$8.4945
New York855,141$10.73$8.5039
Tennessee776,909$10.75$8.5139
Colorado769,231$10.76$8.5048
Virginia760,098$10.71$8.4732
Georgia690,804$10.76$8.5227
North Carolina685,231$10.70$8.5048
New Jersey631,391$10.76$8.5241
Ohio593,885$10.73$8.4827
Indiana496,699$10.72$8.4919
Oklahoma471,128$10.69$8.4819
Alabama433,651$10.71$8.5218
Minnesota378,945$10.73$8.5340
Louisiana344,820$10.72$8.5213
Iowa334,011$10.69$8.5125
Missouri328,131$10.74$8.4819
Wisconsin320,986$10.72$8.4910
Michigan302,358$10.71$8.5323
Nebraska273,840$10.77$8.505
Kansas234,885$10.78$8.518
Oregon216,300$10.73$8.5215
Arkansas208,971$10.64$8.529
Mississippi198,661$10.63$8.5313
Delaware197,820$10.57$8.417
Idaho197,610$10.74$8.475
Alaska178,605$10.74$8.524
Massachusetts173,043$10.79$8.5215
Nevada170,940$10.71$8.495
New Mexico146,265$10.72$8.498
Hawaii130,891$10.51$8.533
Washington122,805$10.76$8.565
District of Columbia121,485$10.76$8.486
Utah105,301$10.64$8.419
Kentucky73,880$10.74$8.528
Wyoming47,670$10.79$8.512
West Virginia39,690$10.81$8.533
Connecticut35,400$10.76$8.513
Puerto Rico31,710$10.31$8.412
New Hampshire21,001$10.71$8.422
North Dakota13,860$10.53$8.671

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.