HCPCS J9075 (Cyclophosphamide) 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 | Low |
| Medicare Payment Limit | $0.481  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J9075 by major payers:
$0.56
$1.19
$1.53
$0.69
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | J9075 | $0.75 | 1336162015 - HEMANGINI SHAH | 202487127 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9075 | $1.04 | 1235462128 - NANDINI IGNATIUS | 852303328 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9075 | $1.24 | 1255300141 - RICHARDS AFONJA | 421634032 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9075 | $0.93 | 1407894322 - ALAN COHLER | 853991596 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9075 | $1.35 | 1235494204 - UROOSA IBRAHIM | 611661781 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9075 | $1.28 | 1073836078 - PROGRESSIVE ACUTE CARE AVOYELLES, LLC, AVOYELLES HOSPITAL PHYSICIAN PRACTICE | 263147245 | LA | General Acute Care Hospital (282N00000X) |
United | J9075 | $1.05 | 1518012400 - CARLINE MICHAUD | 453023019 - (NY) NORTH SHORE-LIJ MEDICAL PC | NY | General Acute Care Hospital (282N00000X) |
United | J9075 | $1.33 | 1720400906 - KRISTEN SPENCER | 135562308 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9075 | $0.87 | 1174625347 - ROGER STRAIR | 223266219 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9075 | $0.87 | 1285734301 - MAYA SHAH | 223680355 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9075 | $1.83 | 1376564302 - INOVA HEALTH CARE SERVICES, INOVA LOUDOUN HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | J9075 | $1.07 | 1043455199 - SISTERS OF CHARITY HOSPITAL, ST. JOSEPH CAMPUS | 160743187 - (NY) SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK | NY | General Acute Care Hospital (282N00000X) |
United | J9075 | $0.98 | 1184664187 - MARK MACHER | 481275162 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9075 | $1.26 | 1134550239 - MARKUS PLATE | 131623978 | NY | General Acute Care Hospital (282N00000X) |
United | J9075 | $0.87 | 1083146435 - MATTHEW DEEK | 223371727 | NJ | Radiation Oncology Physician (2085R0001X) |
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 J9075 vs. Other Chemotherapy Drugs Codes
The HCPCS J9075 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 J9075 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 |
|---|---|---|
| J9075-HCPCS | Low | Injection, cyclophosphamide, not otherwise specified, 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 J9075. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9075 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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