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See a sample rate comparisonHCPCS J0872 (Daptomycin) 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, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J0872 |
| Medicare Payment Limit | $0.038  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J0872 by major payers:
$0.06
$0.05
$2.02
$0.05
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HCPCS J0872
5 of 25 sample ratesHigher to lower in this preview
Bbh Wbmc, LLC, Walker Baptist Medical Center
$0.54Published rateValley Medical Group-Renton, Public Hospital District #1 Of King County
Public Hospital District 1 Of King County
$0.05Published rateAdirondack Medical Center
$0.03Published rateHuntington Vamc
$0.03Published rateCincinnati Vamc
$0.03Published rate
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See a sample payer proposalHCPCS J0872 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0872 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 J0872 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 |
|---|---|---|
| J0872-HCPCS | Low | Injection, daptomycin (xellia), unrefrigerated, not therapeutically equivalent to j0878 or j0873, 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 J0872. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0872 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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