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See a sample rate comparisonHCPCS J1412 (Roctavian) 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, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for J1412 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J1412 by major payers:
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HCPCS J1412
5 of 25 sample ratesHigher to lower in this preview
East Cooper Community Hospital, Inc., East Cooper Medical Center
$14,649.53Published rateCarilion Tazewell Community Hospital
$11,713.70Published rateDulce Health Center, Jicarilla Service Unit
Dulce Health Center
$11,667.96Published rateCommunity Hospital Of Anderson & Madison County, Inc
Community Hospital Of Anderson- Madison County Inc
$11,667.96Published rateMercy Health, Harness Health Pharmacy
Mercy Health - Tiffin Hospital LLC
$7,584.18Published rate
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See a sample payer proposalHCPCS J1412 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1412 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 J1412 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 |
|---|---|---|
| J1412-HCPCS | Moderate | Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1412. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1412 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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