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See a sample rate comparisonHCPCS J3111 (Evenity) 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, romosozumab-aqqg, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office None |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J3111 |
| Medicare Payment Limit | $12.07  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 55513-0880-02 - EVENITY (PF,LATEX-FREE) 105 MG/1.17 ML • 55513-0998-02 - EVENITY (PF,LATEX-FREE) 105 MG/1.17 ML |
National average reimbursement for HCPCS J3111 by major payers:
$12.42
$11.46
$12.51
$11.84
Compare published rates across providers.
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HCPCS J3111
5 of 25 sample ratesHigher to lower in this preview
Thomas Francis
Thomas Francis Do LLC
$11.48Published rateOlasunkanmi Oyetunde
St Nicholas Hospital Of The Hospita Sisters Of The Third Order Of St F
$11.48Published ratePaul Krisa
Medical Associates Of Englewood PC
$11.48Published rateSteven Gerber
Steven L Gerber Md PC
$11.15Published rateCarol Lipsitch
First Care Medical Group Inc
$8.61Published rate
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See a sample payer proposalHCPCS J3111 vs. Other Drugs, Administered by Injection Codes
The HCPCS J3111 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 J3111 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 |
|---|---|---|
| 55513-0880-02-NDC | Moderate | EVENITY (PF,LATEX-FREE) 105 MG/1.17 ML |
| 55513-0998-02-NDC | Moderate | EVENITY (PF,LATEX-FREE) 105 MG/1.17 ML |
| J3110-HCPCS | Low | Injection, teriparatide, 10 mcg |
| J3111-HCPCS | Low | Injection, romosozumab-aqqg, 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 J3111. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J3111 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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