J3398 — Injection, voretigene neparvovec-rzyl, 1 billion vector genomes
J3398 is a HCPCS Level II code for injection, voretigene neparvovec-rzyl, 1 billion vector genomes. 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 J3398 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
- 150 units MAI 2 — Date of Service Edit: Policy · CMS Policy
- outpatient
- 150 units MAI 2 — Date of Service Edit: Policy · 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 J3398
- Long descriptor
- Injection, voretigene neparvovec-rzyl, 1 billion vector genomes
- Short descriptor
- Inj luxturna 1 billion vec g
- Added
- January 1, 2019
- 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 J3398
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J3398 is not quite right, the correct code is very often within a few positions of it.
- J3387Injection, elivaldogene autotemcel, per treatment
- J3389Topical administration, prademagene zamikeracel, per treatment
- J3391Injection, atidarsagene autotemcel, per treatment
- J3392Injection, exagamglogene autotemcel, per treatment
- J3393Injection, betibeglogene autotemcel, per treatment
- J3394Injection, lovotibeglogene autotemcel, per treatment
- J3396Injection, verteporfin, 0.1 mg
- J3397Injection, vestronidase alfa-vjbk, 1 mg
- J3399Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes
- J3400Injection, triflupromazine hcl, up to 20 mgterminated
- J3401Beremagene geperpavec-svdt for topical administration, containing nominal 5 x 10^9 pfu/ml vector genomes, per 0.1 ml
- J3402Injection, remestemcel-l-rknd, per therapeutic dose
- J3403Revakinagene taroretcel-lwey, per implant
- J3404Injection, zopapogene imadenovec-drba suspension, per therapeutic dose
- J3405Injection, onasemnogene abeparvovec-brve, per treatment
- J3410Injection, hydroxyzine hcl, up to 25 mg
Questions about J3398
What is HCPCS code J3398?
J3398 is a HCPCS Level II code for injection, voretigene neparvovec-rzyl, 1 billion vector genomes. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J3398?
The CMS HCPCS file marks J3398 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 J3398 paid under the physician fee schedule?
J3398 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).