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See a sample rate comparisonHCPCS J2469 (Palonosetron) 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, palonosetron HCl, 25 mcg
| Key Fact | Detail |
|---|---|
| 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 Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J2469 |
| Medicare Payment Limit | $0.356  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00143-9513-01 - PALONOSETRON HCL (PF) 0.125 MG/1 ML • 00703-4094-01 - PALONOSETRON HCL (S.D.V.) 0.05 MG/1 ML • 00781-3312-75 - PALONOSETRON HCL 0.05 MG/1 ML • 00781-3312-95 - PALONOSETRON HCL SDV 0.05 MG/1 ML • 00781-3415-75 - PALONOSETRON HCL NOVAPLUS (SDV) 0.05 MG/1 ML |
National average reimbursement for HCPCS J2469 by major payers:
$1.21
$1.33
$2.44
$1.21
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HCPCS J2469
5 of 25 sample ratesHigher to lower in this preview
Philip Clarkson
$2.11Published rateLucyamma Thalody
Thalody Medical Associates LLC
$0.66Published rateGlutality Provider Group Of New Jersey, PA.
Glutality Provider Group Of New Jersey PA
$0.66Published ratePrinceton Specialty Group
Princeton Healthcare Affiliated Physicians PC
$0.62Published rateAndreea Vascan
Orlando Physicians Network Inc
$0.58Published rate
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See a sample payer proposalHCPCS J2469 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2469 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 J2469 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 |
|---|---|---|
| 00143-9513-01-NDC | Moderate | PALONOSETRON HCL (PF) 0.125 MG/1 ML |
| 00703-4094-01-NDC | Moderate | PALONOSETRON HCL (S.D.V.) 0.05 MG/1 ML |
| 00781-3312-75-NDC | Moderate | PALONOSETRON HCL 0.05 MG/1 ML |
| J2469-HCPCS | Low | Injection, palonosetron HCl, 25 mcg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J2469. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2469 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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