HCPCS J0133 (Acyclovir Sodium) 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 |
|---|---|
| Service Type | • Drugs Administered Other than Oral Method • Drugs, Administered by Injection |
| Common Place of Service | • None • 99 - Other POS |
| Complexity Level | Low |
| Medicare Payment Limit | |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 38779-0173-01 - ACYCLOVIR (U.S.P.) • 38779-0173-04 - ACYCLOVIR (U.S.P.) • 38779-0173-05 - ACYCLOVIR (U.S.P.) • 38779-0173-08 - ACYCLOVIR (U.S.P.) • 49452-0001-04 - ACYCLOVIR (U.S.P.) |
National average reimbursement for HCPCS J0133 by major payers:

$0.05

$0.04

$0.05

$0.04
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS J0133 | ||||||
United | J0133 | $0.05 | 1720827264 - MARYLAND ONCOLOGY HEMATOLOGY, P.A. | 541768662 - VIRGINIA ONCOLOGY ASSOCIATES, P.C. | MD | Multi-Specialty Clinic/Center (261QM1300X) |
United | J0133 | $0.05 | 1649306911 - RANCHO CAPISTRANO MEDICAL CLINIC, DANA POINT FAMILY MEDICAL GROUP | 270070586 - (CA) RANCHO CAPISTRANO MEDICAL CLINIC | CA | Clinic/Center (261Q00000X) |
United | J0133 | $0.05 | 1861630410 - LA CLINICA DEL PUEBLO DE RIO ARRIAB, ESCALANTE SCHOOL BASE HEALTH CENTER | 850209845 - (NM) LA CLINICA DELPUEBLO DE RIO ARIBA | NM | Clinic/Center (261Q00000X) |
United | J0133 | $0.02 | 1033465190 - COLUMBIA MEMORIAL HOSPITAL, COLUMBIA MEMORIAL FAMILY CARE (HUDSON) | 141338373 - COLUMBIA MEMORIAL HOSPITAL | NY | Multi-Specialty Clinic/Center (261QM1300X) |
United | J0133 | $0.02 | 1104857549 - GRANGER MEDICAL CLINIC PC, GRANGER MEDICAL WEST JORDAN | 852975223 | UT | Multi-Specialty Clinic/Center (261QM1300X) |
United | J0133 | $0.05 | 1710165568 - MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTER, INC., MVA SHINNSTON MEDICAL CENTER | 550419191 - (WV) MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS INC | WV | Clinic/Center (261Q00000X) |
United | J0133 | $0.15 | 1013942788 - UNITYPOINT AT HOME | 421477471 - UNITYPOINT AT HOME | IA | Home Infusion Therapy Pharmacy (3336H0001X) |
United | J0133 | $0.02 | 1407505142 - ELITE MEDICAL CLINIC, LLC | 873287169 - (GA) ELITE MEDICAL CLINIC LLC | GA | Multi-Specialty Clinic/Center (261QM1300X) |
United | J0133 | $0.02 | 1770237042 - GRACE CLINIC OF LUBBOCK | 203856995 - (TX) GRACE CLINIC OF LUBBOCK | TX | Multi-Specialty Clinic/Center (261QM1300X) |
United | J0133 | $0.05 | 1811217946 - PRIMA MEDICAL FOUNDATION | 271376321 - (CA) PRIMA MEDICAL FOUNDATION | CA | Clinic/Center (261Q00000X) |
United | J0133 | $0.02 | 1922391598 - G PIKOVSKI MD S.C. | 264132983 - (IL) G PIKOVSKI MD SC | IL | Clinic/Center (261Q00000X) |
United | J0133 | $0.02 | 1669756532 - MERCY MEDICAL PARTNERS NORTHERN REGION LLC, MERCY HEALTH PHYSICIANS - DEFIANCE CLINIC | 320350047 - (OH) MERCY MEDICAL PARTNERS NORTHERN REGION LLC | OH | Multi-Specialty Clinic/Center (261QM1300X) |
United | J0133 | $0.01 | 1801992862 - EMERGENCY PHYSICIANS CENTER, FAMILY PHYSICIAN CENTER | 720963803 - (LA) EMERGENCY PHYSICIANS CENTER | LA | Multi-Specialty Clinic/Center (261QM1300X) |
United | J0133 | $0.03 | 1740255025 - AP SURGICAL ASSOCIATES, PA | 202779143 - (TX) AP SURGICAL ASSOCIATES PA | TX | Clinic/Center (261Q00000X) |
United | J0133 | $0.14 | 1700883741 - CHILDREN'S HOME CARE OF DAYTON | 311356037 - (OH) CHILDRENS HOME CARE OF DAYTON | OH | Home Infusion Therapy Pharmacy (3336H0001X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS J0133 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0133 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 J0133 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 |
|---|---|---|
| 38779-0173-01-NDC | Moderate | ACYCLOVIR (U.S.P.) |
| 38779-0173-04-NDC | Moderate | ACYCLOVIR (U.S.P.) |
| J0132-HCPCS | Low | Injection, acetylcysteine, 100 mg |
| J0133-HCPCS | Low | Injection, acyclovir, 5 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0133. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0133 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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