Cosentyx J Code: J3247

Drug & Product Overview

HCPCS Descriptor Injection, secukinumab, intravenous, 1 mg

HCPCS Added Date July 1, 2024

Manufacturer Novartis

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Solution, Concentrate

About Cosentyx

Cosentyx is a medication aligned to the HCPCS J Code: J3247 for billing, pricing, and reimbursement purposes in the United States. It is an Immunology drug administered via the intravenous route and manufactured by Novartis.

According to CMS Drug Use Information: This medication is used to treat certain types of arthritis (such as arthritis of the spine, psoriatic arthritis, axial spondyloarthritis). Secukinumab belongs to a class of drugs known as monoclonal antibodies. It works by blocking a certain natural protein in your body (interleukin-17A) that may cause inflammation and swelling.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. The list of NDCs below is not exhaustive.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
00078-1168-61	Cosentyx	Novartis Pharmaceuticals Corporation	125	125 MG / 5 ML

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Cosentyx Pricing & Reimbursement

J3247 Private Payer Reimbursement

$18.05 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q4 2026

Cosentyx CPT Administration Codes

CPT Code	Description
96365	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)

Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

Cosentyx Medically Unlikely Edits (MUE)

The most billing units of J3247 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg.

Practitioner Office & Hospital Outpatient

1,000 units / day

= 1,000 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

Cosentyx Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Ankylosing Spondylitis Enthesitis-Related Arthritis Hidradenitis Suppurativa Non-Radiographic Axial Spondyloarthritis Plaque Psoriasis Psoriatic Arthritis

Drug Class

Interleukin-17A Antagonist [EPC]Interleukin-17A Antagonists [MoA]

Frequently Asked Questions

Is there an available Cosentyx billing and coding guide?

Billing and coding information for Cosentyx can be found through Novartis Pharmaceuticals Corporation. Visit Here →

Are there any available Cosentyx patient assistance programs?

Cosentyx patient assistance information can be found through Novartis Pharmaceuticals Corporation. Visit Here →

Where can I find Cosentyx prescribing information?

Cosentyx prescribing information can be found at the link below: Visit Here →

Where can I find Cosentyx side effect information?

Information regarding Cosentyx's side effect information can be found at Medline Plus.

Does billing Cosentyx require JZ/JW wastage modifiers?

CMS does not include Cosentyx (J3247) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J3247. For more information, visit the link below.

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