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See a sample rate comparisonHCPCS J9023 (Bavencio) 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, avelumab, 10 mg
| Key Fact | Detail |
|---|---|
| Service Type | Chemotherapy Drugs |
| Common Place of Service | None 11 - Office 22 - On Campus Outpatient Hospital |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J9023 |
| Medicare Payment Limit | $100.087  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J9023 by major payers:
$104.84
$102.19
$103.66
$101.03
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HCPCS J9023
5 of 25 sample ratesHigher to lower in this preview
Fairview Health Services, Fairview Northland Regional Hospital
Fairview Health Services
$175.75Published rateNassau Healthcare Corporation, Nassau Department Of Psychiatry And Psychology, Fpp
$127.54Published rateHarlingen Vamc
$107.93Published rateSaint Alphonsus Medical Center Nampa, Inc.
Saint Alphonsus Medical Center Nampa Inc
$95.18Published rateOhiohealth Corporation, Dublin Methodist Hospital
Ohiohealth Corporation Grant Riverside Doctors Dublin Met
$0.97Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J9023 vs. Other Chemotherapy Drugs Codes
The HCPCS J9023 code is part of the Chemotherapy Drugs services . 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 J9023 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 |
|---|---|---|
| J9022-HCPCS | Low | Injection, atezolizumab, 10 mg |
| J9023-HCPCS | Low | Injection, avelumab, 10 mg |
| J9025-HCPCS | Low | Injection, azacitidine, 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 J9023. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9023 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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