HCPCS J9029 (Adstiladrin) Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Chemotherapy Drugs |
| Common Place of Service | • 11 - Office • None • 22 - On Campus Outpatient Hospital |
| Complexity Level | High |
| Medicare Payment Limit | |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J9029 by major payers:

$53,056.73

$66,126.31

$67,325.28

$64,173.00
| 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 J9029 | ||||||
United | J9029 | $66033.21 | 1548264120 - MICHAEL GREENBERG | 464855345 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9029 | $69690.25 | 1487776373 - SAMEER DESAI | 852303328 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9029 | $70527.15 | 1740367762 - SOUTHWEST MEDICAL CARE CORPORATION | 341444900 - (OH) SOUTHWEST MEDICAL CARE CORPORATION | OH | General Acute Care Hospital (282N00000X) |
United | J9029 | $81753.13 | 1659383669 - YUMI KIM | 364901314 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9029 | $75448.42 | 1306370770 - GHAZAL KANGO | 852303328 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9029 | $70579.78 | 1417997719 - JAMES DALZELL | 200333191 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9029 | $67309.28 | 1225081516 - GADSDEN REGIONAL MEDICAL CENTER LLC, GADSDEN REGIONAL MEDICAL CENTER | 631102774 | AL | General Acute Care Hospital (282N00000X) |
United | J9029 | $57019.28 | 1841816303 - RICHARD MENJIVAR | 208088453 - (NY) SAMARITAN MEDICAL SERVICES PC | NY | General Acute Care Hospital (282N00000X) |
United | J9029 | $60187.03 | 1982695086 - ERICA LINDEN | 810889110 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9029 | $68549.85 | 1003232976 - BANNER HEALTH, BANNER CASA GRANDE MEDICAL CENTER | 450233470 - BANNER HEALTH | AZ | General Acute Care Hospital (282N00000X) |
United | J9029 | $66889.14 | 1982688925 - VIJAY ROY | 223376459 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9029 | $65304.10 | 1750432720 - RAGHU KUNAMNENI | 300937486 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9029 | $70579.78 | 1558315010 - SOUTHWEST HEALTHCARE OF BROWN COUNTY OHIO, LLC, SOUTHWEST REGIONAL MEDICAL CENTER | 316001668 | OH | General Acute Care Hospital (282N00000X) |
United | J9029 | $95103.06 | 1538437579 - CAP COD HOSPITAL | 42103600 - (MA) CAPE COD HEALTHCARE INC | MA | General Acute Care Hospital (282N00000X) |
United | J9029 | $70579.78 | 1043485303 - DAVID D'AMBROSIO | 223444048 | NJ | Radiation Oncology Physician (2085R0001X) |
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 J9029 vs. Other Chemotherapy Drugs Codes
The HCPCS J9029 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 J9029 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 |
|---|---|---|
| J9027-HCPCS | Low | Injection, clofarabine, 1 mg |
| J9029-HCPCS | High | Injection, nadofaragene firadenovec-vncg, per therapeutic dose |
| J9030-HCPCS | Low | BCG live intravesical instillation, 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 J9029. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9029 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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