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See a sample rate comparisonHCPCS J3398 (Luxturna) Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Injection, voretigene neparvovec-rzyl, 1 billion vector genomes
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 22 - On Campus Outpatient Hospital 11 - Office |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for J3398 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J3398 by major payers:
$2,585.27
$3,207.54
$3,171.70
$3,196.49
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HCPCS J3398
5 of 25 sample ratesHigher to lower in this preview
Riverside Middle Peninsula Hospital Inc, Riverside Walter Reed Hospital
Riverside Healthcare Association Inc
$7,617.74Published rateSaint Luke'S North Hospital, Saint Luke'S Norland Hospital-Smithville
Saint Lukes North Hospital
$3,507.04Published rateWhite County Medical Center
$3,137.19Published rateMunster Medical Research Foundation Inc, Community Hospital
Munster Medical Research Foundation Inc
$3,137.19Published rateSuhaib Andrabi
New York City Health And Hospitals Corporation
$2,073.68Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J3398 vs. Other Drugs, Administered by Injection Codes
The HCPCS J3398 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 J3398 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 |
|---|---|---|
| J3397-HCPCS | Moderate | Injection, vestronidase alfa-vjbk, 1 mg |
| J3398-HCPCS | High | Injection, voretigene neparvovec-rzyl, 1 billion vector genomes |
| J3399-HCPCS | High | Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 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 J3398. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J3398 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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