HCPCS J9058 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 | • 11 - Office • None |
| Complexity Level | Low |
National average reimbursement for HCPCS J9058 by major payers:
$18.83
$17.30
$22.66
$17.72
| 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 J9058 | ||||||
United | J9058 | $16.12 | 1063468072 - UNIVERSITY OF SOUTH ALABAMA, USA HEALTH UNIVERSITY HOSPITAL | 630477348 - (AL) UNIVERSITY OF SOUTH ALABAMA | AL | General Acute Care Hospital (282N00000X) |
United | J9058 | $10.06 | 1851777585 - WAJEEHA SAEED | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | J9058 | $16.94 | 1639128473 - MONTROSE VAMC, WAPPINGERS FALLS VAMC | 141630103 | NY | General Acute Care Hospital (282N00000X) |
United | J9058 | $16.12 | 1700809829 - LEGACY SALMON CREEK HOSPITAL | 331065485 - LEGACY SALMON CREEK HOSPITAL | WA | General Acute Care Hospital (282N00000X) |
United | J9058 | $18.81 | 1992755292 - GENEVA COUNTY HEALTHCARE AUTHORITY, INC., WIREGRASS MEDICAL CENTER | 636004474 - (AL) GENEVA COUNTY HEALTH CARE AUTHORITY INC DBA WIREGRASS MEDICAL CENTER | AL | General Acute Care Hospital (282N00000X) |
United | J9058 | $20.86 | 1467494690 - SCOTT STONE | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Medical Oncology Physician (207RX0202X) |
United | J9058 | $15.22 | 1184711798 - CESAR DE LAS CASAS | 592898487 | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9058 | $16.94 | 1588661490 - MOHAMMED QURAISHI | 362671677 - (IL) CAMELOT RADIOLOGY ASSOCIATES, LTD. DBA NORTHERN ILLINOIS RADIOLOGY | TX | Medical Oncology Physician (207RX0202X) |
United | J9058 | $19.47 | 1316111214 - ANGELA COSCIO | 760458535 - BAYLOR ST LUKES MEDICAL GROUP | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9058 | $19.47 | 1396709978 - BAPTIST MEMORIAL HOSPITAL-BOONEVILLE, INC. | 640663760 - (MS) BAPTIST MEMORIAL HOSPITAL BOONEVILLE INC | MS | General Acute Care Hospital (282N00000X) |
United | J9058 | $14.98 | 1457619017 - DIMITRY HIKIN | 113224885 - (NY) ST FRANCIS CARDIAC PREVENTION SERVICES PC | NY | General Acute Care Hospital (282N00000X) |
United | J9058 | $15.22 | 1669462362 - MOUNTAIN VIEW HOSPITAL LLC | 820516012 - MOUNTAIN VIEW HOSPITAL LLC | ID | General Acute Care Hospital (282N00000X) |
United | J9058 | $19.86 | 1194744805 - WEST PENN ALLEGHENY HEALTH SYSTEM INC, THE WESTERN PENNSYLVANIA HOSPITAL | 250969492 - (PA) HIGHMARK HEALTH | PA | General Acute Care Hospital (282N00000X) |
United | J9058 | $20.38 | 1851929954 - MERCY HOSPITAL OF BUFFALO | 160756336 - (NY) MERCY HOSPITAL OF BUFFALO | NY | General Acute Care Hospital (282N00000X) |
United | J9058 | $20.38 | 1164964078 - ADRIELLE EL-DYSON OTOO | 131740114 - MONTEFIORE MEDICAL CENTER | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
HCPCS J9058 vs. Other Chemotherapy Drugs Codes
The HCPCS J9058 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 J9058 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 |
|---|---|---|
| J9057-HCPCS | Low | Injection, copanlisib, 1 mg |
| J9058-HCPCS | Low | Injection, bendamustine hydrochloride (apotex), 1 mg |
| J9059-HCPCS | Low | Injection, bendamustine hydrochloride (baxter), 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 J9058. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9058 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS J9058) and we'll show you how you compare in 15 minutes or less.