Cost analysis for CPT J0897 — Injection, denosumab, 1 mg
Average Medicare Payment
$18.00
2023 data
Total Payments (2023)
$875.0M
Services (2023)
48.0M
Price Change (2014–2023)
+63.2%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $11.03 | $288.0M | 25.9M | — |
| 2015 | $11.45 | $356.1M | 30.8M | +3.8% |
| 2016 | $12.11 | $435.2M | 35.5M | +5.8% |
| 2017 | $12.86 | $496.1M | 38.1M | +6.2% |
| 2018 | $13.85 | $605.5M | 43.1M | +7.7% |
| 2019 | $14.42 | $687.4M | 47.1M | +4.1% |
| 2020 | $15.18 | $696.2M | 45.3M | +5.3% |
| 2021 | $16.06 | $763.3M | 47.0M | +5.8% |
| 2022 | $16.74 | $804.6M | 47.6M | +4.2% |
| 2023 | $18.00 | $875.0M | 48.0M | +7.5% |
The most expensive state pays 1.0x more than the cheapest for this procedure. VT averages $18.55 vs OH at $17.99.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| VT | $18.55 | $260.4K | 14.0K | 2 |
| XX | $18.50 | $26.6K | 1.4K | 1 |
| GU | $18.42 | $170.2K | 9.2K | 1 |
| MT | $18.39 | $353.2K | 19.2K | 13 |
| ID | $18.37 | $2.1M | 112.0K | 27 |
| AK | $18.33 | $2.5M | 135.3K | 30 |
| WI | $18.32 | $4.1M | 223.1K | 59 |
| RI | $18.31 | $605.3K | 33.1K | 9 |
| FL | $18.30 | $112.5M | 6.1M | 1.1K |
| OR | $18.29 | $5.2M | 286.8K | 67 |
| MO | $18.29 | $17.0M | 928.2K | 206 |
| MA | $18.29 | $9.3M | 506.0K | 113 |
| NV | $18.28 | $6.2M | 341.6K | 66 |
| NY | $18.28 | $41.6M | 2.3M | 493 |
| MN | $18.28 | $4.7M | 255.5K | 92 |
| KS | $18.28 | $14.6M | 797.9K | 179 |
| AZ | $18.27 | $29.7M | 1.6M | 257 |
| NE | $18.27 | $12.8M | 699.5K | 204 |
| AR | $18.27 | $14.6M | 800.7K | 163 |
| PA | $18.26 | $47.1M | 2.6M | 526 |
| TX | $18.26 | $51.2M | 2.8M | 647 |
| LA | $18.26 | $7.6M | 416.4K | 72 |
| CO | $18.25 | $9.7M | 531.4K | 141 |
| DE | $18.25 | $7.6M | 415.1K | 57 |
| TN | $18.25 | $20.6M | 1.1M | 243 |
| DC | $18.25 | $1.4M | 75.0K | 15 |
| MI | $18.25 | $11.6M | 635.8K | 168 |
| UT | $18.25 | $5.0M | 272.3K | 74 |
| IA | $18.25 | $14.0M | 767.1K | 189 |
| IL | $18.24 | $36.8M | 2.0M | 405 |
| NC | $18.24 | $27.5M | 1.5M | 431 |
| ND | $18.23 | $2.5M | 139.0K | 41 |
| VA | $18.23 | $30.5M | 1.7M | 342 |
| NJ | $18.22 | $33.3M | 1.8M | 379 |
| WY | $18.22 | $2.7M | 148.6K | 53 |
| IN | $18.21 | $16.3M | 896.9K | 218 |
| MD | $18.21 | $38.9M | 2.1M | 340 |
| SC | $18.21 | $22.3M | 1.2M | 245 |
| SD | $18.20 | $2.1M | 116.1K | 40 |
| ME | $18.18 | $1.6M | 85.6K | 18 |
| NM | $18.18 | $5.4M | 298.9K | 48 |
| PR | $18.16 | $621.1K | 34.2K | 2 |
| OK | $18.16 | $6.6M | 361.4K | 72 |
| NH | $18.14 | $1.6M | 87.3K | 21 |
| HI | $18.13 | $1.8M | 100.5K | 15 |
| CT | $18.13 | $6.4M | 351.4K | 96 |
| MS | $18.11 | $10.9M | 602.4K | 114 |
| CA | $18.08 | $94.4M | 5.2M | 1.0K |
| GA | $18.08 | $26.3M | 1.5M | 292 |
| WA | $18.08 | $8.8M | 486.4K | 152 |
| WV | $18.07 | $955.8K | 52.9K | 19 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Robert Brennan | Infectious Disease | VA | $2.1M | 115.6K | $18.18 |
| Amanda Mckee | Nurse Practitioner | IL | $1.8M | 101.1K | $18.15 |
| Stuart Weinerman | Endocrinology | NY | $1.6M | 88.3K | $18.42 |
| Anthony Botti | Hematology-Oncology | NJ | $1.6M | 86.4K | $18.26 |
| Sarah Finch | Nurse Practitioner | KS | $1.5M | 80.6K | $18.31 |
| Tara Adams | Nurse Practitioner | GA | $1.5M | 79.3K | $18.39 |
| Elizabeth Clayton | Rheumatology | MD | $1.4M | 75.8K | $18.26 |
| Seth Coren | Orthopedic Surgery | FL | $1.3M | 69.6K | $18.29 |
| Rebecca Guio | Nurse Practitioner | IL | $1.3M | 70.1K | $18.07 |
| Jeffrey Weber | Gastroenterology | WI | $1.2M | 67.4K | $18.45 |
| Himmat Gill | Rheumatology | CA | $1.2M | 64.9K | $18.28 |
| Allison Dunne | Physician Assistant | IA | $1.1M | 62.0K | $18.24 |
| Barry Jacobson | Obstetrics & Gynecology | PA | $1.1M | 60.5K | $18.26 |
| Barry Gruber | Rheumatology | NY | $1.1M | 58.9K | $18.35 |
| Lourdes Aponte | Internal Medicine | DE | $1.1M | 57.2K | $18.38 |
| Andrew James | Certified Clinical Nurse Specialist | MO | $1.0M | 55.7K | $18.19 |
| Edward Lewiecki | Internal Medicine | NM | $1.0M | 54.5K | $18.37 |
| Robert Gelfand | Hematology-Oncology | NY | $945.6K | 51.3K | $18.43 |
| Angela Boldo | Endocrinology | FL | $919.8K | 49.8K | $18.47 |
| Ivonne Herrera | Rheumatology | DE | $883.5K | 48.5K | $18.22 |
Based on the data, CPT J0897 shows a 1.0x variation in pricing across states — relatively consistent by Medicare standards.
Costs have increased 63.2% since 2014. 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.