How much does Medicare pay for HCPCS J3315?

Medicare allowed an average of $428.00 per service and paid $338.24 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1241.71, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code J3315?

Injection, triptorelin pamoate, 3.75 mg. It was billed 9,140 times to 1,363 Medicare beneficiaries by 69 providers in 2024.

Which specialty bills J3315 most?

Urology, with 4,459 services from 34 clinicians. Next are Hematology-Oncology, Medical Oncology, Radiation Oncology.

HCPCS J3315

Injection, triptorelin pamoate, 3.75 mg

$428.00Medicare-allowed amount per service, averaged across 9,140 services

Providers submitted

$1241.71

Asking price, not received

Medicare allowed

$428.00

The fee schedule figure

Medicare paid

$338.24

Balance is patient coinsurance

Providers submitted an average of $1241.71 for this code and Medicare allowed $428.00 — 2.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $338.24 (79%); the rest is the patient’s coinsurance and deductible.

Services: 9,140
Beneficiaries: 1,363
Providers billing it: 69
Total allowed: $3,911,920

What Medicare pays for HCPCS J3315

Across 9,140 services billed by 69 providers to 1,363 beneficiaries, Medicare allowed an average of $428.00 per service. That is 6.7 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills J3315

Specialty	Services	Beneficiaries	Avg allowed	Providers
Urology	4,459	658	$428.98	34
Hematology-Oncology	2,511	360	$429.06	17
Medical Oncology	1,008	127	$415.62	7
Radiation Oncology	596	116	$431.32	6
Nurse Practitioner	530	91	$432.65	4
Internal Medicine	36	11	$456.56	1

J3315 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	2,346	$431.73	$342.71	14
Texas	903	$424.17	$343.26	4
U.S. Virgin Islands	726	$427.11	$343.10	2
Georgia	700	$413.12	$332.07	4
California	655	$432.46	$338.31	8
New Jersey	638	$425.33	$344.95	6
Alabama	385	$427.28	$337.24	5
Nevada	325	$410.87	$329.87	2
Ohio	315	$431.39	$341.40	1
Mississippi	281	$435.52	$342.74	2
Oregon	273	$431.63	$341.96	2
Oklahoma	231	$448.29	$361.60	4
Guam	191	$416.07	$337.65	1
South Carolina	183	$434.80	$343.44	2
New York	174	$417.47	$339.00	2
Puerto Rico	164	$422.40	$332.51	2
Washington	117	$445.52	$354.97	1
Arizona	107	$445.39	$354.04	2
Massachusetts	99	$430.91	$336.10	1
North Carolina	90	$430.07	$340.58	1
Missouri	81	$408.18	$321.15	1
Arkansas	78	$454.85	$362.40	1
Tennessee	78	$434.08	$345.85	1

Related codes

J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg$0.97
J3380Injection, vedolizumab, intravenous, 1 mg$21.66
J3304Injection, triamcinolone acetonide, preservative-free, extended-releas$17.28
J3300Injection, triamcinolone acetonide, preservative free, 1 mg$4.35
J3370Injection, vancomycin hcl, 500 mg$2.20
J3360Injection, diazepam, up to 5 mg$5.64

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.