HCPCS J9040 (Bleomycin Sulfate) 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 | $21.525  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00143-9240-01 - BLEOMYCIN (USP,LYOPHILIZED) 15 U • 00143-9241-01 - BLEOMYCIN (USP,LYOPHILIZED) 30 U • 00409-0323-20 - BLEOMYCIN SULFATE NOVAPLUS (S.D.V.) 30 U • 00409-0332-20 - BLEOMYCIN SULFATE NOVAPLUS (S.D.V.) 15 U • 16714-0886-01 - BLEOMYCIN (SDV,PF,LATEX-FREE) 15 U |
National average reimbursement for HCPCS J9040 by major payers:
$25.98
$36.23
$30.25
$27.63
| 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 J9040 | ||||||
United | J9040 | $47.11 | 1255419941 - MANPREET SANGHARI | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Sleep Medicine (Family Medicine) Physician (207QS1201X) |
United | J9040 | $56.02 | 1114182649 - PALO ALTO MEDICAL FOUNDATION, SUTTER SANT CRUZ MAIN 4TH FLOOR | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Non-Pharmacy Dispensing Site (332900000X) |
United | J9040 | $54.50 | 1295171940 - JOSEPH IFOKWE | 941156581 - SUTTER BAY MEDICAL FOUNDATION | NC | Diagnostic Radiology Physician (2085R0202X) |
United | J9040 | $54.50 | 1881198273 - DAVID VU | 680273974 - SUTTER VALLEY MEDICAL FOUNDATION | CA | Student in an Organized Health Care Education/Training Program (390200000X) |
United | J9040 | $56.02 | 1629077946 - LEO CARPENTER | 680273974 - SUTTER VALLEY MEDICAL FOUNDATION | CA | Physician Assistant (363A00000X) |
United | J9040 | $27.73 | 1326215096 - RUCHI PURI | 940562680 - (CA) SUTTER BAY HOSPITALS | CA | Obstetrics & Gynecology Physician (207V00000X) |
United | J9040 | $47.11 | 1104836535 - ELIZABETH ARIAS | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Hospitalist Physician (208M00000X) |
United | J9040 | $21.02 | 1255630026 - XIAO WEI | 42263040 - (MA) DANA-FARBER CANCER INSTITUTE | MA | Medical Oncology Physician (207RX0202X) |
United | J9040 | $43.18 | 1356492011 - ELISABETH BATTINELLI | 42263040 - (MA) DANA-FARBER CANCER INSTITUTE | MA | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9040 | $45.84 | 1669548681 - VINCENT MASON | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Pediatrics Physician (208000000X) |
United | J9040 | $45.84 | 1649294273 - ARCHANA DHAWAN | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Nephrology Physician (207RN0300X) |
United | J9040 | $52.72 | 1609325604 - RABIA ASLAM | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Internal Medicine Physician (207R00000X) |
United | J9040 | $56.02 | 1649596180 - SWAYTHA YALAMANCHI | 941156581 - SUTTER BAY MEDICAL FOUNDATION | CA | Endocrinology, Diabetes & Metabolism Physician (207RE0101X) |
United | J9040 | $54.50 | 1891284014 - GAELEN STANFORD-MOORE | 941156581 - SUTTER BAY MEDICAL FOUNDATION | OR | Otolaryngology/Facial Plastic Surgery Physician (207YX0905X) |
United | J9040 | $74.62 | 1043670342 - SUTTER BAY HOSPITALS, MILLS HEALTH CENTER D/P APH | 940562680 - (CA) SUTTER BAY HOSPITALS | CA | Psychiatric Hospital Unit (273R00000X) |
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 J9040 vs. Other Chemotherapy Drugs Codes
The HCPCS J9040 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 J9040 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 |
|---|---|---|
| 00143-9240-01-NDC | Moderate | BLEOMYCIN (USP,LYOPHILIZED) 15 U |
| J9039-HCPCS | Low | Injection, blinatumomab, 1 microgram |
| J9040-HCPCS | Low | Injection, bleomycin sulfate, 15 units |
| J9041-HCPCS | Low | Injection, bortezomib, 0.1 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9040. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9040 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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