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HCPCS J0225 (Amvuttra) Fee Schedule

Last Verified: October 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Injection, vutrisiran, 1 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

11 - Office

None

Complexity LevelHigh
Medicaid Fee ScheduleView Medicaid rates for J0225
Medicare Payment Limit
$5003.639BuyandBill.com
WAC Price
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Related NDC Codes

• 71336-1003-01 - AMVUTTRA (PF,LATEX-FREE) 25 MG/0.5 ML


National average reimbursement for HCPCS J0225 by major payers:

bcbs

$5,057.91

uhc

$5,032.81

aetna

$5,342.12

cigna

$5,212.93

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J0225.

HCPCS J0225
5 of 25 sample ratesHigher to lower in this preview
  1. Carlos Hartmann

    AZInfectious Disease PhysicianNPI 1962769141Tax ID 72-0276883

    $9,502.20Published rate
  2. Mark Rigo

    Cypress Emergency Associates, PA

    TXFamily Medicine PhysicianNPI 1346237054Tax ID 20-2044998

    $4,947.37Published rate
  3. Cloud Health Medical Group, P.A.

    Cloud Health Medical Group PA

    TNInternal Medicine PhysicianNPI 1528744935Tax ID 93-2013924

    $4,932.10Published rate
  4. Christine Gibson

    AZFamily Medicine PhysicianNPI 1316400070Tax ID 86-0828589

    $4,932.10Published rate
  5. Global Wound Care Medical Group

    CAGeneral Practice PhysicianNPI 1235831132Tax ID 92-2943572

    $4,192.29Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS J0225 vs. Other Drugs, Administered by Injection Codes

The HCPCS J0225 code is part of the Drugs Administered Other than Oral Method services used for Drugs, Administered by Injection. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS J0225 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
71336-1003-01-NDCModerateAMVUTTRA (PF,LATEX-FREE) 25 MG/0.5 ML
J0224-HCPCSModerateInjection, lumasiran, 0.5 mg
J0225-HCPCSHighInjection, vutrisiran, 1 mg
J0248-HCPCSLowInjection, remdesivir, 1 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0225. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J0225 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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