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See a sample rate comparisonHCPCS J0129 (Orencia) Fee Schedule
Last Verified: October 2026
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.
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)
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office None |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J0129 |
| Medicare Payment Limit | $44.109  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00003-2187-13 - ORENCIA (W/SYRINGE,PF) 250 MG • 00003-2188-51 - ORENCIA CLICKJECT (PF) 125 MG/1 ML • 00003-2814-11 - ORENCIA (PF,LYOPHILIZED) 50 MG/0.4 ML • 00003-2818-11 - ORENCIA (SD PREFILLED SYRINGE,PF) 87.5 MG/0.7 ML |
National average reimbursement for HCPCS J0129 by major payers:
$49.76
$49.81
$49.18
$46.44
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HCPCS J0129
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$94.95Published rateRabab Khan
Town Center Pediatrics
$43.79Published rateEvan Rose
$43.43Published rateLittle Elm Medical Clinic PA
$42.84Published rateRicardo Cuadra
Airline Complete Healthcare Of Texas Ltdllp
$32.13Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J0129 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0129 code is part of the Drugs Administered Other than Oral Method services used for Drugs, Administered by Injection. 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 HCPCS J0129 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 |
| 00003-2188-51-NDC | Moderate | ORENCIA CLICKJECT (PF) 125 MG/1 ML |
| 00003-2814-11-NDC | Moderate | ORENCIA (PF,LYOPHILIZED) 50 MG/0.4 ML |
| 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 HCPCS J0129. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0129 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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