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HCPCS J1322 Fee Schedule

Last Verified: November 2025

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

Injection, elosulfase alfa, 1 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

None

99 - Other POS

Common Modifiers
Complexity LevelModerate

National average reimbursement for HCPCS J1322 by major payers:

bcbs

$307.79

uhc

$300.05

aetna

$313.93

cigna

$311.41

Preview provider-level rates for...
For billing codeHCPCS J1322
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J1322

United
J1322$293.921639341266 - SACHIN CHAUDHARY942958258 - BANNER-UNIVERSITY MEDICAL GROUPAZGeneral Acute Care Hospital (282N00000X)
United
J1322$514.351376579557 - EASTERN MAINE HEALTHCARE SYSTEMS INLAND HOSPITAL10217211 - (ME) EASTERN MAINE HEALTHCARE SYSTEMSMEGeneral Acute Care Hospital (282N00000X)
United
J1322$288.541164876546 - BBH PBMC, LLC, PRINCETON BAPTIST MEDICAL CENTER474775351ALGeneral Acute Care Hospital (282N00000X)
United
J1322$293.921144215039 - HIGHLANDS HOSPITAL AND HEALTH CENTER, PENN HIGHLANDS CONNELLSVILLE251494705 - (PA) HIGHLANDS HOSPITAL AND HEALTH CENTERPAGeneral Acute Care Hospital (282N00000X)
United
J1322$293.921487721718 - VICTORIA LEWIS-HOLLAND586011888GAGeneral Acute Care Hospital (282N00000X)
United
J1322$476.081013912633 - THE VALLEY HOSPITAL INC.221487307 - (NJ) VALLEY HOSPITAL INCNJGeneral Acute Care Hospital (282N00000X)
United
J1322$476.081861479545 - MAURY REGIONAL HOSPITAL, MAURY REGIONAL MEDICAL CENTER626002623 - MAURY REGIONAL HOSPITALTNGeneral Acute Care Hospital (282N00000X)
United
J1322$293.921972965861 - CHRISTINA CIRACO900603487 - (NY) PHYSICIAN AFFILIATE GROUP OF NEW YORK PCNYGeneral Acute Care Hospital (282N00000X)
United
J1322$293.921588668842 - HALIFAX REGIONAL HOSPITAL, INC., SENTARA HALIFAX REGIONAL HOSPITAL540648699 - (VA) HALIFAX REGIONAL HOSPITAL INCVAGeneral Acute Care Hospital (282N00000X)
United
J1322$293.921811916281 - FORT HEALTHCARE, INC.390286215 - FORT HEALTHCARE INCWIGeneral Acute Care Hospital (282N00000X)
United
J1322$293.921154573244 - JMC132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATIONNYGeneral Acute Care Hospital (282N00000X)
United
J1322$323.301043240682 - BAPTIST HEALTH, BAPTIST HEALTH MEDICAL CENTER-LITTLE ROCK710236856 - (AR) BAPTIST HEALTHARGeneral Acute Care Hospital (282N00000X)
United
J1322$707.271124135132 - SUTTER DELTA MEDICAL CENTER, DELTA MEMORIAL HOSPITAL940562680 - (CA) SUTTER BAY HOSPITALSCAGeneral Acute Care Hospital (282N00000X)
United
J1322$340.071093740128 - LESTER E COX MEDICAL CENTERS, COX MEDICAL CENTERS440577118 - LESTER E COX MEDICAL CENTERMOGeneral Acute Care Hospital (282N00000X)
United
J1322$283.221942485321 - SUMMIT GUPTA454649755 - (MD) CAPITAL PRIMARY AND GERIATRIC CARE LLCMDGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS J1322 vs. Other Drugs, Administered by Injection Codes

The HCPCS J1322 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 J1322 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
J1320LowInjection, amitriptyline HCl, up to 20 mg
J1322ModerateInjection, elosulfase alfa, 1 mg
J1324LowInjection, enfuvirtide, 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 J1322. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J1322 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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