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See a sample rate comparisonHCPCS J3401 (Vyjuvek) Fee Schedule
Last Verified: October 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.
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| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for J3401 |
| Medicare Payment Limit | $1025.436  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J3401 by major payers:
$1,045.07
$1,208.58
$1,946.60
$1,147.94
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HCPCS J3401
5 of 25 sample ratesHigher to lower in this preview
St. Luke'S Community Health Services, St. Luke'S The Woodlands Hospital
St Lukes Community Health Services
$3,566.79Published rateNicholas H. Noyes Memorial Hospital
Nicholas H Noyes Memorial Hospital
$1,077.79Published rateStonewall Jackson Memorial Hospital Co
Stonewall Jackson Memorial Hospital Company
$1,016.78Published rateSumner Regional Medical Center LLC, Sumner Regional Medical Center
$996.96Published rateRabi Upadhyay
New York City Health And Hospitals Corporation
$658.98Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J3401 vs. Other Drugs, Administered by Injection Codes
The HCPCS J3401 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 J3401 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 |
|---|---|---|
| J3401-HCPCS | High | Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J3401. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J3401 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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