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HCPCS J1190 (Dexrazoxane) Fee Schedule

Last Verified: January 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, dexrazoxane hydrochloride, per 250 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

None

11 - Office

22 - On Campus Outpatient Hospital

Complexity LevelLow
Medicare Payment Limit
$63.06BuyandBill.com
WAC Price
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Related NDC Codes

00143-9247-01 - DEXRAZOXANE (SDV W/DILUENT) 250 MG

00143-9248-01 - DEXRAZOXANE (SDV W/ DILUENT) 500 MG

55150-0434-01 - DEXRAZOXANE (SDV;W/DILUENT,PF) 250 MG

55150-0434-02 - DEXRAZOXANE NOVAPLUS (SDV;W/DILUENT,PF) 250 MG

72205-0247-01 - DEXRAZOXANE SDV,LYOPHILIZED 250 MG


National average reimbursement for HCPCS J1190 by major payers:

bcbs

$94.96

uhc

$104.43

aetna

$120.54

cigna

$100.22

Preview provider-level rates for...
For billing codeHCPCS J1190
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J1190

United
J1190$97.381063457901 - ROBINSON MEMORIAL PORTAGE COUNTY HOSPITAL346003914OHGeneral Acute Care Hospital (282N00000X)
United
J1190$87.481740876382 - DELTA HEALTH SYSTEM, DELTA HEALTH-NORTHWEST REGIONAL853959101MSGeneral Acute Care Hospital (282N00000X)
United
J1190$80.831003232976 - BANNER HEALTH, BANNER CASA GRANDE MEDICAL CENTER450233470 - BANNER HEALTHAZGeneral Acute Care Hospital (282N00000X)
United
J1190$92.731538157508 - SAN JOAQUIN COMMUNITY HOSPITAL952294234 - SAN JOAQUIN COMMUNITY HOSPITAL CORPORATIONCAGeneral Acute Care Hospital (282N00000X)
United
J1190$87.481457358103 - BELLVILLE HOSPITAL DISTRICT, BELLVILLE GENERAL HOSPITAL760636528TXGeneral Acute Care Hospital (282N00000X)
United
J1190$108.011841667458 - CHRISTOPHER ORPIANO453220509 - (CA) REEDLEY COMMUNITY HOSPITALCAGeneral Acute Care Hospital (282N00000X)
United
J1190$488.501598930075 - JESSICA HAYWARD943281660CAGeneral Acute Care Hospital (282N00000X)
United
J1190$166.111831220714 - INOVA HEALTH CARE SERVICES, INOVA FAIRFAX HOSPITAL264587374VAGeneral Acute Care Hospital (282N00000X)
United
J1190$57.831376929489 - NADEZHDA IBRAGIMOVA132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATIONNYGeneral Acute Care Hospital (282N00000X)
United
J1190$108.371952418352 - GENEVA GENERAL HOSPITAL INC.160743032 - (NY) GENEVA GENERAL HOSPITALNYGeneral Acute Care Hospital (282N00000X)
United
J1190$90.041568411791 - MARION VAMC, FORT WAYNE VAMC351516418 - MARION VAMCINGeneral Acute Care Hospital (282N00000X)
United
J1190$100.661477508687 - AURORA HEALTH CARE NORTH, INC., AURORA MEDICAL CENTER MANITOWOC391211629 - (WI) AURORA HEALTH CARE INCWIGeneral Acute Care Hospital (282N00000X)
United
J1190$68.751689653487 - CENTRAL MAINE MEDICAL CENTER10211494 - CENTRAL MAINE MEDICAL CENTERMEGeneral Acute Care Hospital (282N00000X)
United
J1190$122.811598766495 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER,INC720423635 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INCLAGeneral Acute Care Hospital (282N00000X)
United
J1190$90.041265465439 - ADVENTIST MIDWEST HEALTH, UCHICAGO MEDICINE ADVENTHEALTH HINSDALE362276984 - ADVENTIST MIDWEST HEALTHILGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS J1190 vs. Other Drugs, Administered by Injection Codes

The HCPCS J1190 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 J1190 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.

CodeComplexityDescription
00143-9247-01-NDCModerateDEXRAZOXANE (SDV W/DILUENT) 250 MG
J1180-HCPCSLowInjection, dyphylline, up to 500 mg
J1190-HCPCSLowInjection, dexrazoxane hydrochloride, per 250 mg
J1200-HCPCSLowInjection, diphenhydramine HCl, up to 50 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1190. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J1190 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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