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See a sample rate comparisonHCPCS J2323 (Tysabri) Fee Schedule
Last Verified: October 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, natalizumab, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office |
| Complexity Level | Low |
| Medicare Fee Schedule | $23.93 per 1 mg (October 2026 ASP) · View Medicare rates for J2323 |
| Medicaid Fee Schedule | $24.405 median of the 8 states in the free preview · View Medicaid rates for J2323 |
| Medicare Payment Limit | $23.996  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J2323 by major payers:
$26.67
$24.96
$26.67
$25.79
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HCPCS J2323
5 of 25 sample ratesHigher to lower in this preview
Sangeetha Radhakrishnan
Kelsey-Seybold Medical Group PLLC
$70.66Published rateKelsey Richardson
Covenant Medical Group
$24.45Published rateJohn Cunningham
Gastroenterology Consultants Of San Antonio, P.A.
$24.22Published rateJames Prescott
William Newton Memorial Hospital
$24.06Published rateSpecialists Hospital Shreveport, LLC
Specialists Hospital Shreveport, L.L.C.
$23.87Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J2323 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2323 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 J2323 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 |
|---|---|---|
| J2320-HCPCS | Low | Injection, nandrolone decanoate, up to 50 mg |
| J2323-HCPCS | Low | Injection, natalizumab, 1 mg |
| J2325-HCPCS | Low | Injection, nesiritide, 0.1 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J2323. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2323 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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