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See a sample rate comparisonHCPCS J0695 (Zerbaxa) 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, ceftolozane 50 mg and tazobactam 25 mg
| 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 |
| Medicaid Fee Schedule | View Medicaid rates for J0695 |
| Medicare Payment Limit | $9.066  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 67919-0030-01 - ZERBAXA (PF) 1 GM-0.5 GM |
National average reimbursement for HCPCS J0695 by major payers:
$8.54
$8.41
$8.86
$8.69
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HCPCS J0695
5 of 25 sample ratesHigher to lower in this preview
Ganana Tesfa
Medhealth
$24.80Published rateNilanjana Dasgupta
Central Texas Hospitalists, P.A.
$7.54Published rateTexas Partners Healthcare Group, PA
Texas Partners Healthcare Group PA
$7.48Published ratePodiatric Medical Partners Of Texas, PA
Podiatric Medical Partners Of
$7.37Published rateMedical Arts Internal Medicine, P.A.
Medical Arts Internal Medicine P.A.
$4.49Published rate
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See a sample payer proposalHCPCS J0695 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0695 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 J0695 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 |
|---|---|---|
| 67919-0030-01-NDC | Moderate | ZERBAXA (PF) 1 GM-0.5 GM |
| J0694-HCPCS | Low | Injection, cefoxitin sodium, 1 gm |
| J0695-HCPCS | Low | Injection, ceftolozane 50 mg and tazobactam 25 mg |
| J0696-HCPCS | Low | Injection, ceftriaxone sodium, per 250 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0695. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0695 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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