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HCPCS J1324 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, enfuvirtide, 1 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service
Common Modifiers
Complexity LevelModerate

National average reimbursement for HCPCS J1324 by major payers:

bcbs

$1.23

uhc

$0.84

aetna

$7.11

cigna

$7.31

Preview provider-level rates for...
For billing codeHCPCS J1324
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J1324

United
J1324$0.661689624686 - DENVER HEALTH AND HOSPITAL AUTHORITY841343242COGeneral Acute Care Hospital (282N00000X)
United
J1324$0.661972689172 - LAKE HOSPITAL SYSTEM INC, LAKE HEALTH341425870 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INCOHGeneral Acute Care Hospital (282N00000X)
United
J1324$0.691538491949 - EISENHOWER MEDICAL CENTER, EISENHOWER956130458 - EISENHOWER MEDICAL CENTERCAGeneral Acute Care Hospital (282N00000X)
United
J1324$0.661598971855 - OVERLAKE HOSPITAL MEDICAL CENTER LAB910652651 - (WA) OVERLAKE HOSPITAL MEDICAL CENTERWAGeneral Acute Care Hospital (282N00000X)
United
J1324$0.661336391275 - SCOTT MENOLASCINO426037896 - (IA) CRAWFORD COUNTY MEMORIAL HOSPITALNEGeneral Acute Care Hospital (282N00000X)
United
J1324$0.661366573263 - KING'S DAUGHTERS MEDICAL CENTER610444716 - ASHLAND HOSPITAL CORPORATIONMSGeneral Acute Care Hospital (282N00000X)
United
J1324$0.751205220977 - UNIVERSITY MEDICAL CENTER886000436NVGeneral Acute Care Hospital (282N00000X)
United
J1324$0.661760714497 - SAVOY MEDICAL MANAGEMENT GROUP, INC., SAVOY PHYSICIAN SERVICES800202027 - (LA) SAVOY MEDICAL MANAGEMENT GROUP INCLAGeneral Acute Care Hospital (282N00000X)
United
J1324$0.661114908001 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS, ST VINCENT HOSPITAL390817529 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCISWIGeneral Acute Care Hospital (282N00000X)
United
J1324$0.661427154335 - CATHOLIC MEDICAL CENTER20315693 - CATHOLIC MEDICAL CENTERNHGeneral Acute Care Hospital (282N00000X)
United
J1324$0.661811946817 - BILOXI VAMC640836707MSGeneral Acute Care Hospital (282N00000X)
United
J1324$0.801144397134 - UCH-MHS, MEMORIAL HOSPITAL800348943 - POUDRE VALLEY MEDICAL GROUP LLCCOGeneral Acute Care Hospital (282N00000X)
United
J1324$0.661457319154 - ST JOSEPHS HOSPITAL BREESE OF THE HOSPITAL SISTERS OF THE THIRD ORDE, ST. JOSEPH'S HOSPITAL371208459 - (IL) ST JOSEPHS HOSP OF THE HOSP SISTERS OF THE 3RD ORDER OF ST FRANCISILGeneral Acute Care Hospital (282N00000X)
United
J1324$0.511679911572 - EMAD HANNA132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATIONNYGeneral Acute Care Hospital (282N00000X)
United
J1324$0.661649688037 - ALECTO HEALTHCARE SERVICES FAIRMONT LLC, FAIRMONT REGIONAL MEDICAL CENTER471693245WVGeneral 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 J1324 vs. Other Drugs, Administered by Injection Codes

The HCPCS J1324 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 J1324 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
J1322ModerateInjection, elosulfase alfa, 1 mg
J1324LowInjection, enfuvirtide, 1 mg
J1325LowInjection, epoprostenol, 0.5 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1324. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J1324 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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