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See a sample rate comparisonHCPCS J8565 (Iressa) 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.
Gefitinib, oral, 250 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Chemotherapy Drugs, Oral and IV Administration |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J8565 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00310-0482-30 - IRESSA 250 MG • 00480-4053-56 - GEFITINIB (FILM-COATED) 250 MG • 50742-0366-30 - GEFITINIB (FILM-COATED) 250 MG • 60505-4512-03 - GEFITINIB (FILM-COATED) 250 MG • 69339-0168-03 - GEFITINIB (FILM-COATED) 250 MG |
National average reimbursement for HCPCS J8565 by major payers:
$193.43
$148.62
$150.10
$120.68
Compare published rates across providers.
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HCPCS J8565
5 of 25 sample ratesHigher to lower in this preview
Cedars-Sinai Medical Center
$291.29Published rateStephanie Moss
University Of Miami
$177.92Published rateArun Kumar Chandran
Physician Affiliate Group Of New York PC
$140.21Published rateMount Sinai Community Foundation, Sinai Medical Group
Mount Sinai Community Foundation
$140.21Published rateRui Domingues
New York City Health And Hospitals Corporation
$92.68Published rate
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See a sample payer proposalHCPCS J8565 vs. Other Chemotherapy Drugs, Oral and IV Administration Codes
The HCPCS J8565 code is part of the Drugs Administered Other than Oral Method services used for Chemotherapy Drugs, Oral and IV Administration. 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 J8565 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 |
|---|---|---|
| 00310-0482-30-NDC | Moderate | IRESSA 250 MG |
| 00480-4053-56-NDC | Moderate | GEFITINIB (FILM-COATED) 250 MG |
| 50742-0366-30-NDC | Moderate | GEFITINIB (FILM-COATED) 250 MG |
| J8565-HCPCS | Low | Gefitinib, oral, 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 J8565. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J8565 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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