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See a sample rate comparisonHCPCS J1335 (Ertapenem) Fee Schedule
Last Verified: September 2026
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 Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1335 |
| Medicare Payment Limit | $9.86  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00143-9398-10 - ERTAPENEM (SDV,LATEX-FREE) 1 GM • 00143-9429-10 - ERTAPENEM LYOPHILIZED 1 GM • 00409-3510-22 - ERTAPENEM (LYOPHILIZED) 1 GM • 16714-0889-10 - ERTAPENEM (SDV,LYOPHILIZED) 1 GM • 25021-0199-20 - ERTAPENEM SDV,LYOPHILIZED 1 GM |
National average reimbursement for HCPCS J1335 by major payers:
$14.41
$13.06
$16.82
$12.65
Compare published rates across providers.
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HCPCS J1335
5 of 25 sample ratesHigher to lower in this preview
Humboldt Park Health, Physician Specialty
Humboldt Park Health
$54.27Published rateWhhwc LLC, Wellworx Health Hormone And Wellness Clinic
Whhwc LLC
$11.01Published rateSwagel-Wootton Eye Center, Inc, Swagel-Wootton Eye Institute
Swagel/Wootton Eye Center, Ltd.
$10.73Published rateFamily Medical Care, Inc.
Family Medical Care Inc
$10.42Published rateHudson Valley Regional Community Health Centers Inc
$5.30Published rate
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See a sample payer proposalHCPCS 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.
| Code | Complexity | Description |
|---|---|---|
| 00143-9398-10-NDC | Moderate | ERTAPENEM (SDV,LATEX-FREE) 1 GM |
| 00143-9429-10-NDC | Moderate | ERTAPENEM LYOPHILIZED 1 GM |
| 00409-3510-22-NDC | Moderate | ERTAPENEM (LYOPHILIZED) 1 GM |
| J1335-HCPCS | Low | Injection, ertapenem sodium, 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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