HCPCS J3380 (Entyvio) Fee Schedule
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.
| 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 |
| Medicare Payment Limit | |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 64764-0300-20 - ENTYVIO (SDV,PF,LYOPHILIZED) 300 MG |
National average reimbursement for HCPCS J3380 by major payers:

$24.93

$23.13

$25.48

$23.77
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS J3380 | ||||||
United | J3380 | $21.85 | 1811145550 - DANIEL MURPHY | 300791563 | TX | Internal Medicine Physician (207R00000X) |
United | J3380 | $22.87 | 1376535419 - RICHARD KELLY | 751305297 - (TX) CROCKETT CLINIC LLP | TX | Family Medicine Physician (207Q00000X) |
United | J3380 | $23.15 | 1801814249 - PHILIP ADLER | 133544120 - CAREMOUNT MEDICAL, P.C. | MI | Diagnostic Radiology Physician (2085R0202X) |
United | J3380 | $22.26 | 1154551943 - CESAR GARCIA | 746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICT | TX | Internal Medicine Physician (207R00000X) |
United | J3380 | $22.87 | 1922028224 - FABIAN ESPINOSA | 274899655 - (TX) FABIAN E. ESPINOSA MD PA | TX | Internal Medicine Physician (207R00000X) |
United | J3380 | $20.40 | 1891059911 - TARALEE ADAMS | 853986883 - (TX) VMD PRIMARY PROVIDERS SOUTH HILL COUNTRY TEXAS PLLC | TX | Family Medicine Physician (207Q00000X) |
United | J3380 | $22.87 | 1609305424 - MALLORY FORSYTH | 480892178 - (KS) CITIZENS MEDICAL CENTER INC EMPLOYEE BENEFIT TR | KS | Family Medicine Physician (207Q00000X) |
United | J3380 | $33.52 | 1093198475 - ROHIT GUPTA | 264076297 - (NY) LAWRENCE MEDICAL ASSOCIATES PC | NY | Gastroenterology Physician (207RG0100X) |
United | J3380 | $21.85 | 1184844169 - JAMES MCREYNOLDS | 472117443 - (KS) ST ROSE HEALTH CENTER INC | KS | Internal Medicine Physician (207R00000X) |
United | J3380 | $33.52 | 1487815551 - DANIEL FREEDBERG | 133957095 - (NY) THE NEW YORK AND PRESBYTERIAN HOSPITAL | NY | Gastroenterology Physician (207RG0100X) |
United | J3380 | $23.15 | 1356509574 - ROBERT GIANOTTI | 141338310 - ALBANY MEDICAL COLLEGE | NY | Gastroenterology Physician (207RG0100X) |
United | J3380 | $36.66 | 1003923038 - RICHARD KOTY | 133544120 - CAREMOUNT MEDICAL, P.C. | NY | Ophthalmology Physician (207W00000X) |
United | J3380 | $34.29 | 1346310497 - ALISON CAPE | 133544120 - CAREMOUNT MEDICAL, P.C. | MA | Obstetrics & Gynecology Physician (207V00000X) |
United | J3380 | $21.85 | 1063502235 - ANDREW TALAL | 160743187 - (NY) SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK | NY | Gastroenterology Physician (207RG0100X) |
United | J3380 | $24.54 | 1285994095 - JOHN VILLACCI | 133544120 - CAREMOUNT MEDICAL, P.C. | NY | Family Medicine Physician (207Q00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS J3380 vs. Other Drugs, Administered by Injection Codes
The HCPCS J3380 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 J3380 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 |
|---|---|---|
| 64764-0300-20-NDC | Moderate | ENTYVIO (SDV,PF,LYOPHILIZED) 300 MG |
| J3372-HCPCS | Low | Injection, vancomycin hcl (xellia) not therapeutically equivalent to j3370, 500 mg |
| J3380-HCPCS | Low | Injection, vedolizumab, 1 mg |
| J3385-HCPCS | Moderate | Injection, velaglucerase alfa, 100 units |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J3380. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J3380 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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