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See a sample rate comparisonHCPCS J3357 (Stelara) 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.
Ustekinumab, for subcutaneous injection, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office None 99 - Other POS |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J3357 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J3357 by major payers:
$165.06
$172.02
$185.44
$173.37
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HCPCS J3357
5 of 25 sample ratesHigher to lower in this preview
Grady Memorial Hospital Corporation, Grady Health Systems
Emory University
$323.14Published rateMemorial Health Care System Inc., Memorial Hospital
Memorial Health Care System Inc
$159.91Published rateThe Presbyterian Hospital, Novant Health Presbyterian Medical Center
Presbyterian Hospital
$159.91Published rateLung And Chest Medical Associates
$155.88Published rateRui Domingues
New York City Health And Hospitals Corporation
$125.37Published rate
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See a sample payer proposalHCPCS J3357 vs. Other Drugs, Administered by Injection Codes
The HCPCS J3357 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 J3357 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 |
|---|---|---|
| J3357-HCPCS | Low | Ustekinumab, for subcutaneous injection, 1 mg |
| J3358-HCPCS | Low | Ustekinumab, for intravenous injection, 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 J3357. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J3357 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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