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See a sample rate comparisonHCPCS J3396 (Visudyne) Fee Schedule
Medicare rates as of October 2026
HCPCS J3396 is classified under Drugs Administered Other than Oral Method, in the Drugs, Administered by Injection subgroup.
Injection, verteporfin, 0.1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Complexity Level | Low |
| Medicare Fee Schedule | $11.34 per 0.1 mg (October 2026 ASP) · View Medicare rates for J3396 |
| Medicaid Fee Schedule | $11.15 median of the 8 states in the free preview · View Medicaid rates for J3396 |
| Medicare Payment Limit | $11.538  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J3396 by major payers:
$12.21
BCBS / Anthem
$11.90
UnitedHealthcare
$12.67
Aetna
$12.85
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS J3396.
HCPCS J3396
5 of 25 sample ratesHigher to lower in this preview
Sutter Bay Hospitals, Sutter West Bay Hospitals
Sutter Bay Hospitals
$33.65Published rateBertrand Chaffee Hospital
$12.22Published rateBellville Hospital District, Bellville General Hospital
$11.52Published rateHalifax Hospital Medical Center, Halifax Medical Center
$11.52Published rateSaint Lukes Cancer Institute LLC, The Cancer Institute
Saint Lukes Physician Group Inc
$11.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J3396 vs. Other Drugs, Administered by Injection Codes
The table lists codes related to J3396. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| J3385-HCPCS | Moderate | Injection, velaglucerase alfa, 100 units |
| J3396-HCPCS | Low | Injection, verteporfin, 0.1 mg |
| J3397-HCPCS | Moderate | Injection, vestronidase alfa-vjbk, 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 J3396. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J3396 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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