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See a sample rate comparisonHCPCS J0637 (Cancidas) Fee Schedule
Last Verified: September 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, caspofungin acetate, 5 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 99 - Other POS 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J0637 |
| Medicare Payment Limit | $3.541  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00006-3823-10 - CANCIDAS (VIAL) 70 MG • 00781-3421-94 - CASPOFUNGIN ACETATE (PF,LYOPHILIZED) 50 MG • 00781-3423-94 - CASPOFUNGIN ACETATE (PF,LYOPHILIZED) 70 MG • 25021-0194-10 - CASPOFUNGIN ACETATE (SDV,PF,LATEX-FREE) 50 MG • 25021-0195-10 - CASPOFUNGIN ACETATE (SDV,PF,LATEX-FREE) 70 MG |
National average reimbursement for HCPCS J0637 by major payers:
$6.15
$7.18
$8.03
$7.10
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HCPCS J0637
5 of 25 sample ratesHigher to lower in this preview
Mercy Health Youngstown LLC, Mercy Health St Elizabeth Youngstown Hospital
Humility Of Mary Health Partners
$17.71Published rateVaithilingam Arulthasan
Amboy Medical Practice PC
$6.69Published rateBronx Lebanon Hospital Center
Bronxcare Health System
$6.32Published rateHenry County Memorial Hospital
$5.05Published rateSt Francis Hospital, St Frances Physician Assistants
St Francis Hospital
$4.55Published rate
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See a sample payer proposalHCPCS J0637 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0637 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 J0637 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 |
|---|---|---|
| 00006-3823-10-NDC | Moderate | CANCIDAS (VIAL) 70 MG |
| 00781-3421-94-NDC | Moderate | CASPOFUNGIN ACETATE (PF,LYOPHILIZED) 50 MG |
| 00781-3423-94-NDC | Moderate | CASPOFUNGIN ACETATE (PF,LYOPHILIZED) 70 MG |
| J0637-HCPCS | Low | Injection, caspofungin acetate, 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 J0637. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0637 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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