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HCPCS J1335 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, ertapenem sodium, 500 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

None

11 - Office

Common Modifiers
Complexity LevelModerate

National average reimbursement for HCPCS J1335 by major payers:

bcbs

$14.41

uhc

$13.06

aetna

$16.82

cigna

$12.65

Preview provider-level rates for...
For billing codeHCPCS J1335
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J1335

United
J1335$11.011225433436 - EVERYCARE EXPRESS CLINIC464590191 - (MS) EVERYCARE EXPRESS CLINICMSClinic/Center (261Q00000X)
United
J1335$10.421932428075 - MARGARET D. ZIMMERMAN ARNP,PLLC271866053 - (WA) MARGARET D ZIMMERMAN ARNPPLLCWAMulti-Specialty Clinic/Center (261QM1300X)
United
J1335$11.011669424685 - GREENEVILLE URGENT CARE CENTER INC510603966 - TAKOMA REGIONAL HOSPITAL INCTNClinic/Center (261Q00000X)
United
J1335$11.011740774488 - A CARING EMBRACE, PLLC824775395 - (TX) A CARING EMBRACE PLLCTXClinic/Center (261Q00000X)
United
J1335$60.001598189417 - SPEECH AND OCCUPATIONAL THERAPY INSTITUTE CORPORATION, MAGIC LEARNING CENTER464323757 - (FL) SPEECH AND OCCUPATIONAL THERAPY INSTITUTE CORPORATIONFLClinic/Center (261Q00000X)
United
J1335$11.011558312470 - COASTAL FAMILY MEDICINE, INC, FAMILY CARE CENTERS203752291 - (CA) COASTAL FAMILY MEDICINE, INC.CAMulti-Specialty Clinic/Center (261QM1300X)
United
J1335$10.421336470483 - LANCASTER GENERAL MEDICAL GROUP, LANCASTER GENERAL HEALTH EXPRESS - LINCOLN HIGHWAY231365353 - (PA) LANCASTER GENERAL HOSPITALPAClinic/Center (261Q00000X)
United
J1335$11.051205205374 - ANNE LEE815315530 - (NY) HEALTH SHARED PHYSICIANS PLLCNYClinic/Center (261Q00000X)
United
J1335$11.011598435059 - CRH MD MANAGEMENT LLC, PATRIOT URGENT CARE844341929MDMulti-Specialty Clinic/Center (261QM1300X)
United
J1335$54.271275684516 - WELLSPAN PHARMACY, INC., WELLSPAN INFUSION SERVICES232374072 - (PA) WELLSPAN PHARMACY INCPAHome Infusion Therapy Pharmacy (3336H0001X)
United
J1335$10.421134674021 - COLORADO PERMANENTE MEDICAL GROUP, P.C., KAISER PERMANENTE SKYLINE MEDICAL OFFICES840832336 - COLORADO PERMANENTE MEDICAL GROUP, P.C.COClinic/Center (261Q00000X)
United
J1335$11.011194947200 - A.M. PALANCA-CAPISTRANO,M.D. INC.220026573 - (CA) AM PALANCACAPISTRANOMD INCCAClinic/Center (261Q00000X)
United
J1335$10.421477523678 - BLACK HILLS ORTHOPEDIC & SPINE CENTER, INC.460335970 - BLACK HILLS ORTHOPEDIC AND SPINE CENTERSDMulti-Specialty Clinic/Center (261QM1300X)
United
J1335$11.011548695117 - KALISPELL REGIONAL MEDICAL CENTER INC, WESTSHORE MEDICAL CLINIC237293874 - KALISPELL REGIONAL MEDICAL CENTER INCMTClinic/Center (261Q00000X)
United
J1335$11.011235489030 - FIRST SIGHT VISION CARE LLC454877273 - (MD) FIRST SIGHT VISION CARE, LLCMDClinic/Center (261Q00000X)
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 J1335 vs. Other Drugs, Administered by Injection Codes

The HCPCS J1335 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 J1335 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
J1330LowInjection, ergonovine maleate, up to 0.2 mg
J1335LowInjection, ertapenem sodium, 500 mg
J1364LowInjection, erythromycin lactobionate, per 500 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1335. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J1335 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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