J3357 — Ustekinumab, for subcutaneous injection, 1 mg
J3357 is a HCPCS Level II code for ustekinumab, for subcutaneous injection, 1 mg. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of J3357 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 90 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- outpatient
- 90 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for J3357
- Long descriptor
- Ustekinumab, for subcutaneous injection, 1 mg
- Short descriptor
- Ustekinumab sub cu inj, 1 mg
- Added
- January 1, 2011
- BETOS
- O1E
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to J3357
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J3357 is not quite right, the correct code is very often within a few positions of it.
- J3304Injection, triamcinolone acetonide, preservative-free, extended-release, microsphere formulation, 1 mg
- J3305Injection, trimetrexate glucuronate, per 25 mgterminated
- J3310Injection, perphenazine, up to 5 mgterminated
- J3315Injection, triptorelin pamoate, 3.75 mg
- J3316Injection, triptorelin, extended-release, 3.75 mg
- J3320Injection, spectinomycin dihydrochloride, up to 2 gmterminated
- J3350Injection, urea, up to 40 gm
- J3355Injection, urofollitropin, 75 iuterminated
- J3358Ustekinumab, for intravenous injection, 1 mg
- J3360Injection, diazepam, up to 5 mg
- J3364Injection, urokinase, 5000 iu vialterminated
- J3365Injection, iv, urokinase, 250,000 i.u. vialterminated
- J3370Injection, vancomycin hcl, 500 mgterminated
- J3371Injection, vancomycin hcl (mylan), not therapeutically equivalent to j3370, 500 mgterminated
- J3372Injection, vancomycin hcl (xellia), not therapeutically equivalent to j3370, 500 mgterminated
- J3373Injection, vancomycin hydrochloride, 10 mg
Questions about J3357
What is HCPCS code J3357?
J3357 is a HCPCS Level II code for ustekinumab, for subcutaneous injection, 1 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J3357?
The CMS HCPCS file marks J3357 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is J3357 paid under the physician fee schedule?
J3357 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).