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HCPCS J1300 Fee Schedule

Last Verified: December 2025

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$224.631174973028 - PREEYANKA SUNDAR900733283GAGastroenterology Physician (207RG0100X)
United
J1300$225.691467680900 - MATTHEW FIELEKE481088982 - (KS) OLATHE HEALTH PHYSICIANS INCMOFamily Medicine Physician (207Q00000X)
United
J1300$225.691427257526 - THE-NGOC NGUYEN204934871 - (TX) NORTHERN PINES HEALTH PARTNERS PATXFamily Medicine Physician (207Q00000X)
United
J1300$224.631669807244 - AHSAN HAFEEZ271371893OHInternal Medicine Physician (207R00000X)
United
J1300$225.471326305624 - MOHAMMED BAHAA ALDEEN842435109 - (TX) ADNAN MEDICAL SERVICES PLLCTXInternal Medicine Physician (207R00000X)
United
J1300$225.471811982275 - RICHMOND AVENUE FAMILY PRACTICE ASSOCIATES PA, WEST HOUSTON FAMILY PRACTICE ASSOCIATES PA742076515 - (TX) RICHMOND AVENUE FAMILY PRACTICE ASSOCIATES PATXFamily Medicine Physician (207Q00000X)
United
J1300$327.261699811521 - KANSAS UNIVERSITY PHYSICIANS INC, KU INTERNAL MEDICINE481163756 - KANSAS UNIVERSITY PHYSICIANS INCKSInternal Medicine Physician (207R00000X)
United
J1300$225.471235161605 - DAVIN TURNER440580870 - NORTHWEST MEDICAL CENTER ASSOCIATION INCMOFamily Medicine Physician (207Q00000X)
United
J1300$259.891851555411 - DUSTIN TRIPP440577118 - LESTER E COX MEDICAL CENTERMOFamily Medicine Physician (207Q00000X)
United
J1300$225.471285051748 - MANIK AGGARWAL474482186 - (TX) ABKSW PREFERRED HEALTH PARTNERSTXInternal Medicine Physician (207R00000X)
United
J1300$225.691588377204 - ST CATHERINE HOSPITAL, CMG PRIMARY CARE AND OBSTETRICS & GYNECOLOGY LIBERAL480543721 - (KS) ST CATHERINE HOSPITALKSFamily Medicine Physician (207Q00000X)
United
J1300$225.471902961907 - CHARLES WOOD930386793 - LEGACY GOOD SAMARITAN HOSPITAL AND MEDICAL CENTER PAYROLL DEPTORInternal Medicine Physician (207R00000X)
United
J1300$225.471235136979 - SHAMSA SALEEM742574229 - (TX) WELLMED MEDICAL GROUP, P.A.TXFamily Medicine Physician (207Q00000X)
United
J1300$231.551528642170 - AMADO HOLISTICS PLLC, HOLISTIC CARE FAMILY MEDICINE863745753 - (TX) AMADO HOLISTICS PLLCTXFamily Medicine Physician (207Q00000X)
United
J1300$225.691962404707 - LINDA BEAN753002264 - COMMUNTIY HEALTH CENTER OF SOUTHEAST KANSAS INCOKFamily 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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