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HCPCS J7352 (Scenesse) Fee Schedule

Last Verified: December 2025

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 FactDetail
Service Type

Drugs Administered Other than Oral Method

Miscellaneous Drugs

Common Place of Service

None

11 - Office

Complexity LevelHigh
WAC Price
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National average reimbursement for HCPCS J7352 by major payers:

bcbs

$2,657.31

uhc

$3,615.43

aetna

$3,108.93

cigna

$3,201.47

Preview provider-level rates for...
For billing codeHCPCS J7352
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J7352

United
J7352$3566.681740467059 - ST MARY MERCY HOSPITAL203638272MIGeneral Acute Care Hospital (282N00000X)
United
J7352$3780.681396760989 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF SURGERY, FPP113465690NYGeneral Acute Care Hospital (282N00000X)
United
J7352$3566.681033174933 - KING COUNTY PUBLIC HOSPITAL DISTRICT NO. 2, EVERGREENHEALTH MEDICAL CENTER910844563WAGeneral Acute Care Hospital (282N00000X)
United
J7352$3566.681497723407 - COLORADO WEST HEALTHCARE SYSTEM, COMMUNITY HOSPITAL840469270 - COLORADO WEST HEALTHCARE SYSTEMCOGeneral Acute Care Hospital (282N00000X)
United
J7352$3566.681205025145 - ST PETER'S HEALTH810233121 - ST PETERS HEALTHMTGeneral Acute Care Hospital (282N00000X)
United
J7352$3566.681356675003 - LAKE HOSPITAL SYSTEM, INC, LAKE HEALTH341425870 - (OH) UNIVERSITY HOSPITALS HEALTH SYSTEM INCOHGeneral Acute Care Hospital (282N00000X)
United
J7352$3566.681659321693 - PHILADELPHIA VAMC232742804PAGeneral Acute Care Hospital (282N00000X)
United
J7352$3566.681033107743 - CROUSE HEALTH HOSPITAL, INC.160960470 - CROUSE HEALTH HOSPITAL INCNYGeneral Acute Care Hospital (282N00000X)
United
J7352$6459.271548376700 - TISHOMINGO HEALTH SERVICES, INC., TISHOMINGO CO HOSPITAL640741047 - TISHOMINGO HEALTH SERVICES INCMSGeneral Acute Care Hospital (282N00000X)
United
J7352$3566.681982658944 - PALMYRA PARK HOSPITAL, INC., PALMYRA MEDICAL CENTERS721553462GAGeneral Acute Care Hospital (282N00000X)
United
J7352$3566.681669416624 - BUFFALO VAMC, BATAVIA VAMC161447141NYGeneral Acute Care Hospital (282N00000X)
United
J7352$3780.681790727543 - SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK160743187 - (NY) SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORKNYGeneral Acute Care Hospital (282N00000X)
United
J7352$3566.681760498588 - PIEDMONT NEWTON HOSPITAL, INC., NEWTON MEDICAL CENTER582155150 - (GA) PIEDMONT NEWTON HOSPITAL INCGAGeneral Acute Care Hospital (282N00000X)
United
J7352$3388.361649431388 - HCA PHYSICIAN SERVICES621821475 - (FL) HCA PHYSICIAN SERVICES, INC.FLGeneral Acute Care Hospital (282N00000X)
United
J7352$3780.681447307806 - CYNTHIA LIAPES453023019 - (NY) NORTH SHORE-LIJ MEDICAL PCNYGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS 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.

CodeComplexityDescription
J7351-HCPCSModerateInjection, bimatoprost, intracameral implant, 1 microgram
J7352-HCPCSHighAfamelanotide implant, 1 mg
J7402-HCPCSLowMometasone 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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