NDC 00003-2187-13 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Complexity Level | Moderate |
| Related HCPCS Codes | • J0129 - Injection, abatacept, 10 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
National average reimbursement for NDC 00003-2187-13 by major payers:
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NDC 00003-2187-13 vs. Other Codes
The NDC 00003-2187-13 code is part of the null services . It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The NDC 00003-2187-13 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 00003-2187-13-NDC | Moderate | ORENCIA (W/SYRINGE,PF) 250 MG |
| J0129-HCPCS | Low | Injection, abatacept, 10 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including NDC 00003-2187-13. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 00003-2187-13 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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