J3357 HCPCS code: Ustekinumab, for subcutaneous injection, 1 mg
J3357 is the HCPCS Level II code for ustekinumab, for subcutaneous injection, 1 mg. In 2024 Medicare paid an average of $84.59 per service for J3357 across 19,937 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 90 per day on outpatient hospital claims. Medicare volume fell 91% from 2022 to 2024 (232,387 to 19,937 services). In 2024, about 174 clinicians billed Medicare for J3357 for 146 beneficiaries; Georgia, Ohio, Alabama accounted for 72% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2011-01-01 |
| Last action effective | 2017-01-01 |
Who bills J3357 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 174 |
| Medicare beneficiaries | 146 |
| States with claims | 5 |
| Share of services in top 3 states (Georgia, Ohio, Alabama) | 72% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J3357, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 232,387 | 1,411 | $156.89 | $125.30 |
| 2023 | 16,760 | 159 | $113.17 | $90.13 |
| 2024 | 19,937 | 146 | $105.93 | $84.59 |
States with the most J3357 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Georgia | 4,324 | $92.12 |
| Ohio | 3,337 | $72.79 |
| Alabama | 3,285 | $112.62 |
| North Carolina | 2,869 | $107.79 |
| Kentucky | 1,421 | $0.80 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 90 | Clinical: Data |
| practitioner claims | 90 | Clinical: Data |
What changed for J3357
- 2011-01-01: J3357 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J3357?
J3357 is the HCPCS Level II code for ustekinumab, for subcutaneous injection, 1 mg. Short descriptor: "Ustekinumab sub cu inj, 1 mg".
How much does Medicare pay for J3357?
In 2024, the average Medicare payment was $84.59 per service (average allowed $105.93).
Does Medicare cover J3357?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J3357 can be billed per day?
90 on outpatient hospital claims; 90 on practitioner claims (NCCI medically unlikely edits).
Related J33 codes
- J3300 — Injection, triamcinolone acetonide, preservative free, 1 mg
- J3301 — Injection, triamcinolone acetonide, not otherwise specified, 10 mg
- J3302 — Injection, triamcinolone diacetate, per 5 mg
- J3303 — Injection, triamcinolone hexacetonide, per 5 mg
- J3304 — Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg
- J3305 — Injection, trimetrexate glucuronate, per 25 mg
- J3310 — Injection, perphenazine, up to 5 mg
- J3315 — Injection, triptorelin pamoate, 3.75 mg
- J3316 — Injection, triptorelin, extended-release, 3.75 mg
- J3320 — Injection, spectinomycin dihydrochloride, up to 2 gm
- J3350 — Injection, urea, up to 40 gm
- J3355 — Injection, urofollitropin, 75 iu
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Next steps
- Run a reimbursement report for a device billed under J3357
- Watch J3357 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J3357
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.