HCPCS J9023 (Bavencio) Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Chemotherapy Drugs |
| Common Place of Service | • None • 11 - Office • 22 - On Campus Outpatient Hospital |
| Complexity Level | Low |
| 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
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS J9023 | ||||||
United | J9023 | $0.97 | 1801937008 - OHIOHEALTH CORPORATION, DUBLIN METHODIST HOSPITAL | 314394942 - OHIOHEALTH CORPORATION GRANT RIVERSIDE DOCTORS DUBLIN MET | OH | General Acute Care Hospital (282N00000X) |
United | J9023 | $95.18 | 1659371870 - SAINT ALPHONSUS MEDICAL CENTER NAMPA, INC. | 820200896 - SAINT ALPHONSUS MEDICAL CENTER NAMPA INC | ID | General Acute Care Hospital (282N00000X) |
United | J9023 | $95.18 | 1487651857 - OKLAHOMA SURGICAL HOSPITAL, LLC | 731573733 - (OK) OKLAHOMA SURGICAL HOSPITAL, LLC | OK | General Acute Care Hospital (282N00000X) |
United | J9023 | $115.37 | 1053508820 - HUTCHINSON HEALTH, HUTCHINSON HEALTH HOSPITAL | 841715908 - (MN) HUTCHINSON HEALTH | MN | General Acute Care Hospital (282N00000X) |
United | J9023 | $156.30 | 1851390967 - UHS OF TEXOMA, INC, TEXOMA MEDICAL CENTER | 205908627 - UHS OF TEXOMA INC | TX | General Acute Care Hospital (282N00000X) |
United | J9023 | $95.18 | 1548357973 - DECATUR MEMORIAL HOSPITAL | 370661199 - DECATUR MEMORIAL HOSPITAL | IL | General Acute Care Hospital (282N00000X) |
United | J9023 | $129.91 | 1487901351 - MEMORIAL HOSPITAL, ALBANY, N.Y., CAPITAL DISTRICT INTERNAL MEDICINE | 141338544 - SAMARITAN HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | J9023 | $107.93 | 1508199621 - SERGE LARTCHENKO M.D., PLLC | 270839735 - (TX) SERGE LARTCHENKO MD PLLC | TX | General Acute Care Hospital (282N00000X) |
United | J9023 | $95.18 | 1174660120 - UNIVERSITY OF MARYLAND MEDICAL CENTER, LLC, UNIVERSITY OF MARYLAND MEDICAL CENTER | 320443777 | MD | General Acute Care Hospital (282N00000X) |
United | J9023 | $95.18 | 1396908695 - ALKA BASIL | 363097297 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | General Acute Care Hospital (282N00000X) |
United | J9023 | $100.88 | 1376624981 - PROVIDENCE HEALTH & SERVICES WASHINGTON, PROVIDENCE CENTRALIA HOSPITAL | 910573108 - (WA) PROVIDENCE HEALTH & SERVICES WASHINGTON | WA | General Acute Care Hospital (282N00000X) |
United | J9023 | $96.94 | 1639160799 - CHRISTUS HEALTH CENTRAL LOUISIANA, CHRISTUS ST. FRANCES CABRINI HOSPITAL | 720408984 - (LA) CHRISTUS HEALTH CENTRAL LOUISIANA | LA | General Acute Care Hospital (282N00000X) |
United | J9023 | $100.41 | 1396792032 - RIVER OAKS HOSPITAL LLC, MERIT HEALTH RIVER OAKS | 640626874 - (MS) RIVER OAKS HOSPITAL LLC | MS | General Acute Care Hospital (282N00000X) |
United | J9023 | $145.30 | 1447284898 - MERCY HOSPITAL LEBANON, MERCY HOSPITAL LEBANON | 431767432 - MERCY HOSPITAL LEBANON | MO | General Acute Care Hospital (282N00000X) |
United | J9023 | $127.54 | 1902822992 - NASSAU HEALTHCARE CORPORATION, NASSAU DEPARTMENT OF PSYCHIATRY AND PSYCHOLOGY, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS 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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