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See a sample rate comparisonHCPCS J3485 (Retrovir) 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, zidovudine, 10 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J3485 |
| Medicare Payment Limit | $1.513  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 49702-0213-26 - RETROVIR (SINGLE USE,PF) 10 MG/1 ML |
National average reimbursement for HCPCS J3485 by major payers:
$1.60
$1.55
$1.68
$1.61
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HCPCS J3485
5 of 25 sample ratesHigher to lower in this preview
Sutter Tracy Community Hospital
Sutter Valley Hospitals
$4.82Published rateMercy Hospital, Inc.
Mercy Hospital Inc
$1.75Published rateColorado West Healthcare System, Community Hospital
Colorado West Healthcare System
$1.50Published rateSalisbury Vamc
$1.50Published rateZachary Macdonald
New York City Health And Hospitals Corporation
$1.17Published rate
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See a sample payer proposalHCPCS J3485 vs. Other Drugs, Administered by Injection Codes
The HCPCS J3485 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 J3485 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 |
|---|---|---|
| 49702-0213-26-NDC | Moderate | RETROVIR (SINGLE USE,PF) 10 MG/1 ML |
| J3480-HCPCS | Low | Injection, potassium chloride, per 2 mEq |
| J3485-HCPCS | Low | Injection, zidovudine, 10 mg |
| J3486-HCPCS | Low | Injection, ziprasidone mesylate, 10 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J3485. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J3485 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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