HCPCS J9052 (Carmustine) 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 |
| Complexity Level | Moderate |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J9052 by major payers:
$N/A
$778.82
$N/A
$N/A
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | J9052 | $2322.41 | 1922459163 - MSK MONMOUTH | 300937486 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9052 | $2254.78 | 1194011478 - MANISH DAVE | 454832340 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9052 | $2322.41 | 1992142046 - WILLIAM RAFELSON | 300937486 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9052 | $2683.18 | 1487141065 - NISHANT SHAH | 852303328 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9052 | $2029.30 | 1356442602 - PATRICK LEE | 223357053 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9052 | $2378.79 | 1891979381 - MICHAEL LEVITT | 223376459 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9052 | $2254.78 | 1427156017 - ANA MARIA LOPEZ | 461420853 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9052 | $2254.78 | 1467870113 - NEEL TRIVEDI | 223266219 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9052 | $2480.26 | 1790396281 - TITAN HEALTH PARTNERS LLC, ASTERA CANCER CARE | 852303328 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9052 | $2029.30 | 1295154680 - NICHOLAS DENUNZIO | 223371727 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9052 | $2390.07 | 1457395766 - THE UNITY HOSPITAL OF ROCHESTER, UNITY PHYSICIAN SERVICES | 237221763 - THE UNITY HOSPITAL OF ROCHESTER | NY | General Acute Care Hospital (282N00000X) |
United | J9052 | $2254.78 | 1538491212 - JASON SUH | 465285330 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9052 | $2480.26 | 1346202439 - MICHELE DONATO | 223141761 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9052 | $2254.78 | 1700866951 - ROSHINI GEORGE | 454832340 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9052 | $2378.79 | 1982688925 - VIJAY ROY | 223376459 | NJ | Hematology & Oncology Physician (207RH0003X) |
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 J9052 vs. Other Chemotherapy Drugs Codes
The HCPCS J9052 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 J9052 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 |
|---|---|---|
| J9052-HCPCS | Moderate | Injection, carmustine (accord), not therapeutically equivalent to j9050, 100 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9052. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9052 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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