HCPCS J9047 (Kyprolis) 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 | $55.647  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 76075-0101-01 - KYPROLIS 60 MG • 76075-0102-01 - KYPROLIS (LYOPHILIZED) 30 MG • 76075-0103-01 - KYPROLIS (LYOPHILIZED) 10 MG |
National average reimbursement for HCPCS J9047 by major payers:
$55.36
$53.43
$54.61
$52.63
| 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 J9047 | ||||||
United | J9047 | $55.09 | 1588953764 - STUART WINKLER | 834257679 - LORI MYERS MD PC / MANIX MEDICAL INC / MEDICAL FOUNDATION INC | TX | Gynecologic Oncology Physician (207VX0201X) |
United | J9047 | $71.22 | 1538426622 - ANIL SINGH | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9047 | $57.84 | 1841298387 - ANIRUDHA DASGUPTA | 760528826 - (TX) MILLENNIUM PHYSICIANS ASSOCIATION, PLLC | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9047 | $62.58 | 1386136794 - IFEANYICHUKWU ONUKOGU | 203639329 - ALBANY MEDICAL COLLEGE / AMEL BADR MD PC / BEDFORD MEMORIAL HOSPITAL | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9047 | $69.63 | 1225535008 - ANAM KAMAL | 741613878 - (TX) BAYLOR COLLEGE OF MEDICINE | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9047 | $51.97 | 1457395303 - CHIH- HAO CHOU | 752616977 - CHRISTUS TRINITY CLINIC | TX | Rheumatology Physician (207RR0500X) |
United | J9047 | $70.73 | 1801203633 - ANAUM MAQSOOD | 300520570 - (TX) METHODIST HOSPITAL | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9047 | $44.16 | 1467409425 - BRICIA TORO DE ZAREI M.D. P.A., SOUTH TEXAS ARTHRITIS CENTER | 203186931 - (TX) BRICIA TORO DE ZAREI MD PA | TX | Rheumatology Physician (207RR0500X) |
United | J9047 | $99.77 | 1447297965 - MARIA JUAREZ | 911947573 - (TX) BAYLOR FAMILY MEDICAL CENTER AT ELLIS COUNTY LLP / BAYLOR UNIVERSITY MEDICAL CENTER / HEALTH TEXAS PROVIDER NETWORK | TX | Medical Oncology Physician (207RX0202X) |
United | J9047 | $51.97 | 1073760187 - SHALIN SHAH | 760010407 - CENTRAL NEW YORK BRAIN SPINE NEUROSURGERY PLLC / ELIZABETH GORDON MD PA / UNIVERSITY OF TEXAS MEDICAL BRANCH | TX | Radiation Oncology Physician (2085R0001X) |
United | J9047 | $71.22 | 1295152395 - AENA PATEL | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9047 | $52.61 | 1184604902 - YADVINDERA BAINS | 43651560 - CANCER PHYSICIANS ASSOCIATED | TX | Radiation Oncology Physician (2085R0001X) |
United | J9047 | $55.09 | 1063415735 - MARY MILAM | 751755030 - (TX) MARY MILAM MD PA | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9047 | $133.97 | 1710982277 - SARAH HOSFORD | 410834920 - PARK NICOLLET HEALTH SERVICES | TX | Gynecologic Oncology Physician (207VX0201X) |
United | J9047 | $167.36 | 1639281066 - KIRKWOOD JOHNSTON | 760386391 - KELSEY-SEYBOLD MEDICAL GROUP PLLC | TX | Rheumatology Physician (207RR0500X) |
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 J9047 vs. Other Chemotherapy Drugs Codes
The HCPCS J9047 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 J9047 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 |
|---|---|---|
| 76075-0101-01-NDC | Moderate | KYPROLIS 60 MG |
| J9046-HCPCS | Low | Injection, bortezomib, (dr. reddy's), not therapeutically equivalent to j9041, 0.1 mg |
| J9047-HCPCS | Low | Injection, carfilzomib, 1 mg |
| J9048-HCPCS | Low | Injection, bortezomib (fresenius kabi), not therapeutically equivalent to j9041, 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 J9047. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9047 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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