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See a sample rate comparisonHCPCS J0139 (Humira) 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, adalimumab, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for J0139 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J0139 by major payers:
$760.90
$182.46
$N/A
$0.00
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HCPCS J0139
5 of 25 sample ratesHigher to lower in this preview
Ujuka Iloabuchi
$247.44Published rateMichael Koch
Chestatee Pathology Associates PC
$159.24Published rateWildwood Sanitarium Incorporated, Wildwood Medical Clinic
Wildwood Sanitarium Incorporated
$159.24Published rateLeigh Taylor
$159.24Published rateMedway Infusion Services LLC
$143.32Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J0139 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0139 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 J0139 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 |
|---|---|---|
| J0139-HCPCS | Moderate | Injection, adalimumab, 1 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0139. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0139 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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