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See a sample rate comparisonHCPCS J7352 (Scenesse) 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.
Afamelanotide implant, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Miscellaneous Drugs |
| Common Place of Service | None 11 - Office |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for J7352 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J7352 by major payers:
$2,657.31
$3,615.43
$3,108.93
$3,201.47
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HCPCS J7352
5 of 25 sample ratesHigher to lower in this preview
The Charlotte-Mecklenburg Hospital Authority, Carolinas Healthcare System Lincoln
$8,738.38Published rateUva Prince William Medical Center, Uva Health Prince William Medical Center
Uva Prince William Medical Center
$3,923.36Published rateKing County Public Hospital District No. 2, Evergreenhealth Medical Center
$3,566.68Published rateColorado West Healthcare System, Community Hospital
Colorado West Healthcare System
$3,566.68Published rateCanonsburg General Hospital
Highmark Health
$2,873.33Published rate
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See a sample payer proposalHCPCS J7352 vs. Other Miscellaneous Drugs Codes
The HCPCS J7352 code is part of the Drugs Administered Other than Oral Method services used for Miscellaneous Drugs. 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 J7352 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 |
|---|---|---|
| J7351-HCPCS | Moderate | Injection, bimatoprost, intracameral implant, 1 microgram |
| J7352-HCPCS | High | Afamelanotide implant, 1 mg |
| J7402-HCPCS | Low | Mometasone furoate sinus implant, (sinuva), 10 micrograms |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7352. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7352 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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