Cost analysis for CPT J0717 — Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
Average Medicare Payment
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Total Payments (Latest)
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Services (Latest)
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Price Change (–)
N/A
The most expensive state pays 1.0x more than the cheapest for this procedure. RI averages $3.92 vs HI at $3.82.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| RI | $3.92 | $522.3K | 133.2K | 2 |
| MS | $3.91 | $1.6M | 405.0K | 11 |
| MN | $3.91 | $96.3K | 24.6K | 3 |
| NY | $3.91 | $4.8M | 1.2M | 26 |
| OR | $3.91 | $587.9K | 150.4K | 5 |
| AZ | $3.91 | $4.9M | 1.3M | 20 |
| ID | $3.91 | $392.4K | 100.4K | 2 |
| WV | $3.91 | $315.7K | 80.8K | 1 |
| WI | $3.91 | $439.9K | 112.6K | 3 |
| NH | $3.90 | $150.9K | 38.7K | 1 |
| SD | $3.90 | $526.9K | 135.0K | 3 |
| UT | $3.90 | $3.9M | 994.4K | 10 |
| CO | $3.90 | $1.5M | 378.4K | 11 |
| KS | $3.90 | $2.2M | 565.2K | 11 |
| NJ | $3.90 | $13.6M | 3.5M | 62 |
| OH | $3.90 | $2.7M | 683.2K | 9 |
| VA | $3.90 | $11.6M | 3.0M | 32 |
| IA | $3.90 | $1.5M | 385.4K | 16 |
| FL | $3.90 | $35.1M | 9.0M | 116 |
| PA | $3.90 | $14.8M | 3.8M | 66 |
| ME | $3.89 | $252.3K | 64.8K | 1 |
| SC | $3.89 | $5.8M | 1.5M | 21 |
| NE | $3.89 | $2.1M | 532.4K | 5 |
| WA | $3.89 | $561.9K | 144.4K | 4 |
| CT | $3.89 | $1.0M | 267.3K | 8 |
| MA | $3.89 | $676.9K | 174.0K | 4 |
| IL | $3.89 | $10.0M | 2.6M | 41 |
| AR | $3.89 | $3.1M | 786.9K | 11 |
| LA | $3.89 | $2.6M | 676.7K | 10 |
| NV | $3.88 | $1.2M | 318.6K | 5 |
| NC | $3.88 | $6.4M | 1.7M | 36 |
| DE | $3.88 | $4.1M | 1.1M | 11 |
| IN | $3.88 | $3.0M | 768.2K | 15 |
| OK | $3.88 | $1.5M | 395.2K | 6 |
| MT | $3.88 | $77.6K | 20.0K | 1 |
| TN | $3.88 | $6.1M | 1.6M | 23 |
| AL | $3.88 | $3.2M | 837.0K | 9 |
| MD | $3.87 | $5.6M | 1.5M | 25 |
| NM | $3.87 | $1.0M | 264.0K | 4 |
| MI | $3.87 | $775.9K | 200.4K | 5 |
| TX | $3.87 | $24.8M | 6.4M | 91 |
| GA | $3.87 | $3.4M | 875.6K | 17 |
| MO | $3.87 | $3.6M | 940.0K | 14 |
| CA | $3.87 | $13.7M | 3.5M | 42 |
| DC | $3.86 | $635.9K | 164.6K | 2 |
| KY | $3.86 | $7.5M | 1.9M | 26 |
| HI | $3.82 | $603.5K | 158.0K | 1 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Vinicius Costa Diniz Domingues | Rheumatology | FL | $3.8M | 983.8K | $3.91 |
| Nehal Gandhi | Rheumatology | PA | $2.0M | 507.6K | $3.87 |
| Vipul Joshi | Rheumatology | FL | $1.3M | 340.0K | $3.91 |
| Raza Hashmi | Rheumatology | TN | $1.2M | 321.2K | $3.87 |
| Richard Haddad | Rheumatology | NJ | $1.2M | 313.2K | $3.90 |
| Tyler Hobbs | Nurse Practitioner | UT | $1.1M | 277.2K | $3.91 |
| Rajpreet Singh | Rheumatology | TX | $1.1M | 286.4K | $3.73 |
| David Carleton | Rheumatology | VA | $1.1M | 270.8K | $3.90 |
| William Chafin | Rheumatology | GA | $1.1M | 270.4K | $3.90 |
| William Sunshine | Rheumatology | FL | $1.0M | 264.8K | $3.92 |
| Phong Nguyen | Rheumatology | VA | $1.0M | 264.4K | $3.92 |
| Mohamed Aboyoussef | Rheumatology | FL | $1.0M | 262.0K | $3.88 |
| Michael Grant | Rheumatology | UT | $996.5K | 255.0K | $3.91 |
| John Brittis | Rheumatology | SC | $983.0K | 252.0K | $3.90 |
| Joy Schechtman | Rheumatology | AZ | $943.7K | 241.2K | $3.91 |
| Janet Leon | Rheumatology | KY | $941.8K | 242.6K | $3.88 |
| Anupam Chahal | Rheumatology | CA | $922.5K | 236.4K | $3.90 |
| Claude Abujrab-Saba | Internal Medicine | VA | $922.2K | 235.6K | $3.91 |
| Mariam Ameri | Rheumatology | MD | $917.8K | 238.4K | $3.85 |
| Marc Hirsh | Rheumatology | FL | $902.8K | 232.0K | $3.89 |
Based on the data, CPT J0717 shows a 1.0x variation in pricing across states — relatively consistent by Medicare standards.
Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.