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See a sample rate comparisonHCPCS J2355 (Oprelvekin) 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, oprelvekin, 5 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J2355 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J2355 by major payers:
$181.53
$560.65
$454.74
$465.41
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HCPCS J2355
5 of 25 sample ratesHigher to lower in this preview
Fairview Health Services, University Of Mn Medical Center, Fairview
$958.83Published rateThe Good Samaritan Hospital Of Maryland, Inc, Medstar Good Samaritan Hospital
The Good Samaritan Hospital Of Maryland Inc
$560.65Published rateSanta Fe Indian Hospital
$528.91Published rateUch-Mhs
Poudre Valley Medical Group LLC
$528.91Published rateSutter Valley Hospitals, Sutter Solano Medical Center
Sutter Valley Hospitals
$4.03Published rate
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See a sample payer proposalHCPCS J2355 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2355 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 J2355 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 |
|---|---|---|
| J2354-HCPCS | Low | Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg |
| J2355-HCPCS | Low | Injection, oprelvekin, 5 mg |
| J2356-HCPCS | Low | Injection, tezepelumab-ekko, 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 J2355. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2355 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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