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HCPCS J3357: Ustekinumab, Subcutaneous Injection, 1 mg

HCPCS Level II code J3357 designates ustekinumab measured as 1 mg for subcutaneous injection. Ustekinumab is a monoclonal antibody used in several immune-mediated conditions; accurately reporting the drug unit is essential for claims processing, utilization tracking, and payment determination across outpatient and ambulatory care settings. Nationally, biologic drug codes like J3357 are central to specialty drug billing and oversight due to high unit costs and dosing variability.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for ustekinumab, typical sites of service for subcutaneous administration, and the role of the J3357 code in billing. The publication also summarizes benchmarks and billing considerations relevant to payers, common modifier usage (where available), and how this HCPCS Level II code interacts with claims workflows.

What readers will learn: how J3357 is used on medical claims, the clinical setting and service type tied to the code, payer coverage landscape, and where to look for policy updates or coding guidance. Data not available in the input: detailed payer-specific reimbursement rates, associated ICD-10 diagnoses, related codes, service line specifics, and provider taxonomies.

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Billing Code Overview

HCPCS Level II code J3357 describes ustekinumab, for subcutaneous injection, 1 mg. This code represents the medication unit of ustekinumab supplied for subcutaneous administration and is used to report the drug quantity on medical claims.

Service type: Subcutaneous biologic drug administration

Typical site of service: Outpatient clinic, physician office, infusion or injection center, or other ambulatory care settings where subcutaneous biologic injections are administered.

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HCPCS J3357: Ustekinumab, Subcutaneous Injection, 1 mg

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Get alerted when payer policies referencing J3357 are released or updated.

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Billing Code Overview

Service type: Subcutaneous biologic drug administration

Typical site of service: Outpatient clinic, physician office, infusion or injection center, or other ambulatory care settings where subcutaneous biologic injections are administered.

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with moderate to severe plaque psoriasis, psoriatic arthritis, or Crohn disease who requires maintenance or induction biologic therapy with subcutaneous ustekinumab. The patient presents to an outpatient infusion/medication clinic, specialty dermatology clinic, or gastroenterology clinic for administration. The clinical workflow includes verification of diagnosis and prior authorization, pre-administration screening (infection symptoms, tuberculosis screening review, current medications, pregnancy status), medication reconciliation, patient education about expected effects and adverse events, preparation of the appropriate dose (drawn or prefilled syringe, based on weight and indication), subcutaneous injection by a licensed clinician or documented self-administration when appropriate, and observation for immediate adverse reactions (typically 15–30 minutes). Documentation includes the drug name and HCPCS code J3357, lot number, expiration date, units administered, site of administration, any applicable modifier (for example JW for discarded drug), patient vitals, and consent or refusal. Billing may be submitted to payors such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare according to their coverage and prior authorization policies.

Coding Specifications

Modifier	Description	When to Use
`JW`	Drug amount discarded/not administered	Use when part of the vial or prefilled syringe is discarded and documentation supports discarded amount.
`JZ`	No drug administered, patient received zero dose	Use when billed drug not administered but reporting is required for inventory tracking.
`QS`	Monitored anesthesia care (not applicable)	Data not available in the input.
`52`	Reduced services	Use when an ordered service is partially reduced or not completed.
`53`	Discontinued procedure	Use when administration is started but discontinued due to an adverse event or emergency.
`59`	Distinct procedural service (not in list)	Data not available in the input.
`76`	Repeat procedure by same physician (not in list)	Data not available in the input.
`KX`	Requirements specified in the medical policy are met	Use when the provider documents medical necessity per payor policy (e.g., prior authorization criteria).
`22`	Increased procedural services	Use when additional, documented work is required beyond typical administration (for example, extended monitoring due to reaction).
`78`	Unplanned return to operating/procedure room (applicable for procedures)	Use if a patient requires an unplanned immediate return for management of a complication related to administration.
`80`	Assistant at surgery (generally not used)	Use only if an assistant is documented and allowable by payor policy.
`AS`	Non-physician anesthetist	Not typically applicable to subcutaneous injection; include only if services involve an anesthesia professional.
`JW`	Discarded drug (duplicate entry avoided)	See above entry for `JW`.

Taxonomy Code	Specialty	Notes
`207N00000X`	Dermatology	Primary specialty prescribing and administering ustekinumab for plaque psoriasis.
`207W00000X`	Rheumatology	Manages psoriatic arthritis indications and biologic therapy.
`207VG0300X`	Gastroenterology	Prescribes ustekinumab for Crohn disease and ulcerative colitis.
`363L00000X`	Infusion Clinic/Drug Therapy Administration	Clinicians and facilities that administer injectable biologics.
`331Y00000X`	Allergy & Immunology	May manage biologic therapy for select immune-mediated diseases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L40.0`	Psoriasis vulgaris	Primary indication for ustekinumab in moderate to severe plaque psoriasis.
`L40.5`	Arthropathic psoriasis	Psoriatic arthritis presentation treated with systemic biologic therapy.
`M07.0`	Distal interphalangeal psoriatic arthropathy	Specific psoriatic arthritis code reflecting joint involvement responsive to biologics.
`K50.90`	Crohn's disease, unspecified, unspecified site, without complications	Gastroenterology indication for ustekinumab induction and maintenance therapy.
`K51.90`	Ulcerative colitis, unspecified, without complications	Another inflammatory bowel disease indication for biologic therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common pre-administration or follow-up visit for dose assessment, prior authorization, and documentation.
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Used for reporting the act of subcutaneous injection when payor requires an administration CPT in addition to HCPCS.
`96401`	Chemotherapy administration, subcutaneous or intramuscular; non-chemotherapy, initial encounter (note: rarely used)	Occasionally used in some billing scenarios for biologic administration when specified by payor; verify local policy.
`99070`	Supplies and equipment provided by the physician over and above those usually included with the office visit	Used for additional supplies related to drug preparation and administration when separately payable.
`G0463`	Hospital outpatient clinic visit for assessment and management of a patient	Used for facility-level clinic visits associated with administration in a hospital outpatient setting.

Related Codes

HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

HCPCS J0120: Injection, Tetracycline, Up to 250 mg

HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

HCPCS J0121: Omadacycline Injection, 1 mg

HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

HCPCS J0122: Injection, Eravacycline, 1 mg

HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

HCPCS J0129: Abatacept Injection, 10 mg

HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

HCPCS Level II J0130: Injection abciximab, 10 mg

HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

HCPCS J0131: Injection Acetaminophen, 10 mg

HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

HCPCS J0132: Injection, Acetylcysteine 100 mg

HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

HCPCS J0133: Injection, Acyclovir 5 mg

HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

HCPCS J0134: Injection, Acetaminophen (Fresenius Kabi), 10 mg

Showing 1–10 of 991

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`JW`	Drug amount discarded/not administered	Use when part of the vial or prefilled syringe is discarded and documentation supports discarded amount.
`JZ`	No drug administered, patient received zero dose	Use when billed drug not administered but reporting is required for inventory tracking.
`QS`	Monitored anesthesia care (not applicable)	Data not available in the input.
`52`	Reduced services	Use when an ordered service is partially reduced or not completed.
`53`	Discontinued procedure	Use when administration is started but discontinued due to an adverse event or emergency.
`59`	Distinct procedural service (not in list)	Data not available in the input.
`76`	Repeat procedure by same physician (not in list)	Data not available in the input.
`KX`	Requirements specified in the medical policy are met	Use when the provider documents medical necessity per payor policy (e.g., prior authorization criteria).
`22`	Increased procedural services	Use when additional, documented work is required beyond typical administration (for example, extended monitoring due to reaction).
`78`	Unplanned return to operating/procedure room (applicable for procedures)	Use if a patient requires an unplanned immediate return for management of a complication related to administration.
`80`	Assistant at surgery (generally not used)	Use only if an assistant is documented and allowable by payor policy.
`AS`	Non-physician anesthetist	Not typically applicable to subcutaneous injection; include only if services involve an anesthesia professional.
`JW`	Discarded drug (duplicate entry avoided)	See above entry for `JW`.

Taxonomy Code	Specialty	Notes
`207N00000X`	Dermatology	Primary specialty prescribing and administering ustekinumab for plaque psoriasis.
`207W00000X`	Rheumatology	Manages psoriatic arthritis indications and biologic therapy.
`207VG0300X`	Gastroenterology	Prescribes ustekinumab for Crohn disease and ulcerative colitis.
`363L00000X`	Infusion Clinic/Drug Therapy Administration	Clinicians and facilities that administer injectable biologics.
`331Y00000X`	Allergy & Immunology	May manage biologic therapy for select immune-mediated diseases.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`L40.0`	Psoriasis vulgaris	Primary indication for ustekinumab in moderate to severe plaque psoriasis.
`L40.5`	Arthropathic psoriasis	Psoriatic arthritis presentation treated with systemic biologic therapy.
`M07.0`	Distal interphalangeal psoriatic arthropathy	Specific psoriatic arthritis code reflecting joint involvement responsive to biologics.
`K50.90`	Crohn's disease, unspecified, unspecified site, without complications	Gastroenterology indication for ustekinumab induction and maintenance therapy.
`K51.90`	Ulcerative colitis, unspecified, without complications	Another inflammatory bowel disease indication for biologic therapy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common pre-administration or follow-up visit for dose assessment, prior authorization, and documentation.
`96372`	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular	Used for reporting the act of subcutaneous injection when payor requires an administration CPT in addition to HCPCS.
`96401`	Chemotherapy administration, subcutaneous or intramuscular; non-chemotherapy, initial encounter (note: rarely used)	Occasionally used in some billing scenarios for biologic administration when specified by payor; verify local policy.
`99070`	Supplies and equipment provided by the physician over and above those usually included with the office visit	Used for additional supplies related to drug preparation and administration when separately payable.
`G0463`	Hospital outpatient clinic visit for assessment and management of a patient	Used for facility-level clinic visits associated with administration in a hospital outpatient setting.

Related Codes

HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

HCPCS J0120: Injection, Tetracycline, Up to 250 mg

HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

HCPCS J0121: Omadacycline Injection, 1 mg

HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

HCPCS J0122: Injection, Eravacycline, 1 mg

HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

HCPCS J0129: Abatacept Injection, 10 mg

HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

HCPCS Level II J0130: Injection abciximab, 10 mg

HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

HCPCS J0131: Injection Acetaminophen, 10 mg

HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

HCPCS J0132: Injection, Acetylcysteine 100 mg

HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

HCPCS J0133: Injection, Acyclovir 5 mg

HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

HCPCS J0134: Injection, Acetaminophen (Fresenius Kabi), 10 mg

Showing 1–10 of 991

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

HCPCS J3357: Ustekinumab, Subcutaneous Injection, 1 mg

Sign up for hcpcs J3357 policy alerts

Billing Code Overview

HCPCS J3357: Ustekinumab, Subcutaneous Injection, 1 mg

Sign up for hcpcs J3357 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code J3357 represent?

Which modifiers are commonly used with J3357 and when should they be applied?

Where and how is ustekinumab (J3357) typically administered?

What CPT or other procedure codes are commonly associated with billing J3357?

What diagnoses and specialties are commonly associated with J3357 claims?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does HCPCS code J3357 represent?

Which modifiers are commonly used with J3357 and when should they be applied?

Where and how is ustekinumab (J3357) typically administered?

What CPT or other procedure codes are commonly associated with billing J3357?

What diagnoses and specialties are commonly associated with J3357 claims?

References