CareCost Vials
1 × 300 mg
1 billing unit = 1 mg
300 mg dose → 300 billing units
J3380 · vedolizumab
300 mg single-dose vial · JZ on every infusion, JW never applies
Calculate this patient's units ↓300 mg at weeks 0, 2 and 6, then 300 mg every 8 weeks; the dose never changes
J3380 × 300 JZ, not split with a JW line for an amount that does not exist.
This Entyvio claim carries straight into Claim Check.
Claim Check builds the whole visit — J3380 units, the administration line, the modifiers and the Medicare allowed amount — and prices it against your payer's rate. The estimate turns the same visit into what the patient owes.
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Patient owes, 300 mg
Change the payer and the estimate re-prices against that payer's own published rate. The result is a good faith estimate for the patient.
J3380 bills 1 unit per 1 mg: ordered dose ÷ 1 mg = billing units. A 300 mg infusion is 300 units. Entyvio has one dose for both approved indications, and that dose does not change between the three induction infusions and every maintenance infusion after; only the interval changes: weeks 0, 2 and 6 during induction, then every 8 weeks in maintenance.
Entyvio ships in one vial size: a 300 mg lyophilized powder in a single-dose vial, reconstituted with 4.8 mL and diluted into a 250 mL bag before infusion. One infusion draws exactly one vial, so JZ (no drug discarded) is the modifier on every Entyvio claim, and JW never applies: there is no partial vial to discard.
Medicare pays $20.949 per 1 mg (ASP+6%), effective for claims in Q4 2026: $6,284.70
for the 300-unit dose, plus $67.14 for the 96365 infusion administration, for $6,351.84 total before
coinsurance.
Entyvio has no claim-example table to distinguish an induction dose from a maintenance dose, because the dose is the same 300 mg either way. A maintenance infusion administers 300 mg over about 30 minutes: one 300 mg vial, billed JZ because nothing is discarded, and one initial hour of infusion administration. The claim line reads:
| Code | Description | Units | Modifier |
|---|---|---|---|
| J3380 | Vedolizumab, 1 mg | 300 | JZ |
| 96365 | IV infusion, therapeutic, initial hour | 1 | — |
The same claim line applies at week 0, week 2, week 6, and every 8-week maintenance infusion after that. A payer that has approved every-4-week dosing as an escalation does not change this line; it changes how often the claim is submitted, not the 300 units on it.
JZ — no discarded drug from a single-dose container. JW — discarded drug from a single-dose container, reported on its own claim line. One of the two is required on every J3380 claim per CMS's July 1, 2023 single-dose container policy.
J3380 × 300 JZ · 96365 × 1. Because Entyvio has one vial size and one dose,
this arithmetic is the same at every infusion, induction and maintenance alike, and JW never appears on an
Entyvio claim.
96365 covers the initial hour of a therapeutic, prophylactic or diagnostic infusion. Entyvio's roughly 30-minute infusion fits inside that window, so bill 96365 alone; the add-on code 96366 needs 31 or more minutes beyond the first hour, so it does not apply to a 30-minute infusion. 96413, the chemotherapy administration family, is the wrong code for Entyvio: it is a gut-selective integrin receptor antagonist, not a cytotoxic agent, unless a specific payer's own policy says otherwise.
The daily limit on this code is 300 units, exactly the 300 mg dose the label gives for both indications. A claim at that dose sits right at the limit; a claim line above 300 units for a single day fails the edit. Some payers allow an every-4-week escalation of the same 300 mg dose (see the coverage page) rather than the label's every-8-week maintenance interval; that changes how often a 300-unit claim can be submitted, not the limit itself.
Entyvio ships in one size: a 300 mg lyophilized powder in a single-dose vial, reconstituted with 4.8 mL and diluted into a 250 mL bag before infusion. J3380 (“Injection, vedolizumab, 1 mg”) is the HCPCS code for Entyvio IV, and no vedolizumab biosimilar exists. Other infused therapies for ulcerative colitis and Crohn's disease bill under their own codes: Remicade (infliximab, J1745), Stelara IV induction (ustekinumab, J3358), Skyrizi IV induction (risankizumab-rzaa, J2327) and Simponi Aria (golimumab, J1602), each with its own dose and its own claim line. The subcutaneous 108 mg Entyvio pen and prefilled syringe carry no HCPCS code at all: a pharmacy-benefit product dispensed by specialty pharmacy, not billed on a medical claim. See the FDA Entyvio label (BLA 125476) for full dosing and administration instructions, or the current Medicare rate for J3380 →.
300 billing units. J3380 bills 1 unit per 1 mg, and 300 mg is the only dose the label gives for Entyvio, at induction and at every maintenance infusion after it.
JZ, on every infusion. Entyvio's single 300 mg vial matches its single 300 mg dose exactly, so nothing is ever discarded from the vial, and JW does not apply.
300 units per day for J3380, exactly the 300 mg dose. A claim at that dose sits right at the limit; anything billed above it on the same day is denied.
No. Entyvio's infusion runs about 30 minutes, inside the first hour that 96365 already covers, so 96366 (each additional hour) does not apply. 96413 is the chemotherapy administration family; Entyvio is a non-oncology integrin receptor antagonist, so 96413 is the wrong code unless a specific payer policy says otherwise.
No. The 108 mg subcutaneous pen and prefilled syringe carry no HCPCS code. They are a pharmacy-benefit product dispensed by a specialty pharmacy, not billed on a medical claim, so they never appear alongside J3380 on a buy-and-bill claim.
Data current: pricing Q4 2026 · payer policies Aug 2026
Sources: CMS ASP pricing files (Q4 2026); FDA-approved prescribing information (ENTYVIO label, DailyMed, BLA 125476); CMS single-dose container JW/JZ policy (effective July 1, 2023); CMS NCCI MUE table (practitioner services, 2026 Q3); CPT codebook administration-code guidance; 30 commercial payer medical policies in the vedolizumab Clearance corpus.
Reviewed September 21, 2026 by Erin Rose, CareCost Estimate founder. Methodology →