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See a sample rate comparisonHCPCS J7504 (Atgam) Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Immunosuppressive Drugs |
| Common Place of Service | 11 - Office None |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for J7504 |
| Medicare Payment Limit | $5135.09  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00009-7224-02 - ATGAM (AMP,5X5ML) 50 MG/ML |
National average reimbursement for HCPCS J7504 by major payers:
$3,690.93
$4,163.74
$4,120.16
$4,176.23
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HCPCS J7504
5 of 25 sample ratesHigher to lower in this preview
Cedars-Sinai Medical Center
$9,049.45Published rateSt. David'S Healthcare Partnership, L.P., LLP, St. David'S South Austin Medical Center
$4,858.75Published rateAtlanticare Regional Medical Center
Atlanticare Health System Inc
$3,982.59Published rateHarrison Medical Center, Harrison Memorial Hospital
Harrison Medical Center
$3,968.44Published ratePlano Surgical Hospital
$3,968.44Published rate
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See a sample payer proposalHCPCS J7504 vs. Other Immunosuppressive Drugs Codes
The HCPCS J7504 code is part of the Drugs Administered Other than Oral Method services used for Immunosuppressive Drugs. 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 J7504 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 |
|---|---|---|
| 00009-7224-02-NDC | Moderate | ATGAM (AMP,5X5ML) 50 MG/ML |
| J7503-HCPCS | Low | Tacrolimus, extended release, (Envarsus XR), oral, 0.25 mg |
| J7504-HCPCS | High | Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7504. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7504 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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