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HCPCS J9074 (Cyclophosphamide (Sandoz)) Fee Schedule

Last Verified: October 2026

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.

Injection, cyclophosphamide (sandoz), 5 mg
Key FactDetail
Service Type

Chemotherapy Drugs

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for J9074
Medicare Payment Limit
$3.936BuyandBill.com
WAC Price
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National average reimbursement for HCPCS J9074 by major payers:

bcbs

$3.94

uhc

$4.37

aetna

$7.38

cigna

$4.44

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J9074.

HCPCS J9074
5 of 25 sample ratesHigher to lower in this preview
  1. Homaira Omar

    North Shore-Lij Medical PC

    NYGeneral Acute Care HospitalNPI 1881018224Tax ID 45-3023019

    $5.82Published rate
  2. Richard Greenberg

    NJHematology & Oncology PhysicianNPI 1902803349Tax ID 23-2865181

    $4.82Published rate
  3. Memorial Sloan Kettering Cancer Center At Basking Ridge New Jersey

    NJMedical Oncology PhysicianNPI 1184637886Tax ID 59-3801080

    $4.48Published rate
  4. Hussam Eltoukhy

    NJHematology (Internal Medicine) PhysicianNPI 1356737324Tax ID 22-3316007

    $4.34Published rate
  5. Iuliana Shapira

    NJHematology & Oncology PhysicianNPI 1760553762Tax ID 11-3190652

    $3.70Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS J9074 vs. Other Chemotherapy Drugs Codes

The HCPCS J9074 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 J9074 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.

CodeComplexityDescription
J9074-HCPCSLowInjection, cyclophosphamide (sandoz), 5 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9074. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J9074 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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