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See a sample rate comparisonHCPCS J2425 (Kepivance) Fee Schedule
Last Verified: September 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, palifermin, 50 micrograms
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J2425 |
| Medicare Payment Limit | $35.553  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J2425 by major payers:
$31.49
$33.74
$32.72
$31.78
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HCPCS J2425
5 of 25 sample ratesHigher to lower in this preview
The Medical Center Inc, Piedmont Columbus Regional Midtown
The Medical Center Inc
$100.80Published rateMercy Health Youngstown LLC, Mercy Health St Elizabeth Youngstown Hospital
Humility Of Mary Health Partners
$34.70Published rateEast Orange Vamc
$33.99Published rateFreeman-Oak Hill Health System
Freeman Neosho Hospital
$33.06Published rateRam Parekh
New York City Health And Hospitals Corporation
$21.86Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J2425 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2425 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 J2425 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 |
|---|---|---|
| J2410-HCPCS | Low | Injection, oxymorphone HCl, up to 1 mg |
| J2425-HCPCS | Low | Injection, palifermin, 50 micrograms |
| J2426-HCPCS | Low | Injection, paliperidone palmitate extended release (invega sustenna), 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 J2425. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2425 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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