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HCPCS J1300 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, eculizumab, 10 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

11 - Office

None

Complexity LevelModerate

National average reimbursement for HCPCS J1300 by major payers:

bcbs

$237.28

uhc

$230.05

aetna

$246.56

cigna

$238.88

Preview provider-level rates for...
For billing codeHCPCS J1300
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J1300

United
J1300$225.471366463168 - NELSON LIM822652498 - (AZ) ARIZONA CENTERS FOR DIGESTIVE HEALTH, PLLCAZGastroenterology Physician (207RG0100X)
United
J1300$224.631093005704 - MEGAN GILLEM752566987TXFamily Medicine Physician (207Q00000X)
United
J1300$225.691538389390 - MARIYA LYUBENOVA-IVANOVA900743550 - (MO) ST ANTHONYS PHYSICIAN ORGANIZATION HOSPITALIST SERVICES LCMOInternal Medicine Physician (207R00000X)
United
J1300$224.631831400597 - DAVID BYRON830540117 - (AZ) ESCALERA HEALTH LLCAZFamily Medicine Physician (207Q00000X)
United
J1300$224.631295806750 - NEIL SCHWARTZMAN581728803 - NOVANT MEDICAL GROUP INCNCInternal Medicine Physician (207R00000X)
United
J1300$224.631871881300 - HERMANJEET GREWAL823673989 - (TX) CTMC PATXFamily Medicine Physician (207Q00000X)
United
J1300$225.691467680900 - MATTHEW FIELEKE481088982 - (KS) OLATHE HEALTH PHYSICIANS INCMOFamily Medicine Physician (207Q00000X)
United
J1300$224.631326582164 - THE KNEE CLINIC PC811937340 - (TX) THE KNEE CLINIC PCTXFamily Medicine Physician (207Q00000X)
United
J1300$224.631457353500 - BEENA TRIVEDI751402815 - (TX) T R CLINIC A PROFESSIONAL ASSOCIATIONTXFamily Medicine Physician (207Q00000X)
United
J1300$225.471942891478 - VITAVIA TELEMEDICINE PLLC850613278 - (TX) VITAVIA TELEMEDICINE PLLCTXFamily Medicine Physician (207Q00000X)
United
J1300$225.471144327875 - AKHTAR HUSSAIN261525357 - (TX) PROCARE INTERNAL MEDICINE ASSOCIATES PLLCTXInternal Medicine Physician (207R00000X)
United
J1300$224.631770093130 - WICHITA MEDICAL GROUP PLLC823027558 - (TX) WICHITA MEDICAL GROUP PLLCTXFamily Medicine Physician (207Q00000X)
United
J1300$225.471245276682 - STEVEN FOSTER742926290 - (TX) STEVEN K FOSTER MD PATXGeneral Practice Physician (208D00000X)
United
J1300$225.471043257645 - AJAZ KHAN833527998 - (TX) AYMANCARE PLLCTXFamily Medicine Physician (207Q00000X)
United
J1300$225.251366886939 - CLEBURNE INTEGRATED WELLNESS PA461174034 - (TX) CLEBURNE INTEGRATED WELLNESS PATXFamily Medicine Physician (207Q00000X)
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 J1300 vs. Other Drugs, Administered by Injection Codes

The HCPCS J1300 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 J1300 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
J1290-HCPCSModerateInjection, ecallantide, 1 mg
J1300-HCPCSModerateInjection, eculizumab, 10 mg
J1301-HCPCSLowInjection, edaravone, 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 J1300. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J1300 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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