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See a sample rate comparisonHCPCS J3397 (Mepsevii) 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, vestronidase alfa-vjbk, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 99 - Other POS |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for J3397 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 69794-0001-01 - MEPSEVII (PF) 2 MG/1 ML |
National average reimbursement for HCPCS J3397 by major payers:
$250.79
$277.33
$274.41
$279.17
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HCPCS J3397
5 of 25 sample ratesHigher to lower in this preview
The Charlotte-Mecklenburg Hospital Authority, Atrium Health Cleveland
$665.44Published rateMercy Hospitals East Communities, Mercy Hospital St Louis
Mercy Hospitals East Communities
$423.70Published rateNew Orleans Vamc
$271.60Published ratePrescott Vamc
$271.60Published rateKing'S Daughters Medical Center
Kings Daughters Medical Center
$256.76Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J3397 vs. Other Drugs, Administered by Injection Codes
The HCPCS J3397 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 J3397 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 |
|---|---|---|
| 69794-0001-01-NDC | Moderate | MEPSEVII (PF) 2 MG/1 ML |
| J3396-HCPCS | Low | Injection, verteporfin, 0.1 mg |
| J3397-HCPCS | Moderate | Injection, vestronidase alfa-vjbk, 1 mg |
| J3398-HCPCS | High | Injection, voretigene neparvovec-rzyl, 1 billion vector genomes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J3397. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J3397 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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