HCPCS J9145 (Darzalex) 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 | $71.371  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J9145 by major payers:
$72.62
$70.30
$72.06
$69.21
| 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 J9145 | ||||||
United | J9145 | $69.23 | 1427188416 - ARTHRITIS AND RHEUMATISM CENTER P.A. | 710947746 - (TX) ARTHRITIS & RHEUMATISM CENTER, P.A. | TX | Rheumatology Physician (207RR0500X) |
United | J9145 | $65.31 | 1134613532 - MITCHELL VON ITZSTEIN | 756002868 - ABKSW PREFERRED HEALTH PARTNERS PLLC / ACTION FAMILY CARE PLLC / ADAM S MINER MD PA | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9145 | $87.25 | 1003058900 - AARON LAINE | 752512142 - (TX) ONCOLOGYHEMATOLOGY CONSULTANTS PA | TX | Radiation Oncology Physician (2085R0001X) |
United | J9145 | $72.70 | 1013263110 - URMEEL PATEL | 760528826 - (TX) MILLENNIUM PHYSICIANS ASSOCIATION, PLLC | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9145 | $65.31 | 1326579863 - IOANA BONDRE | 760459500 - U T PHYSICIANS | TX | Gynecologic Oncology Physician (207VX0201X) |
United | J9145 | $65.31 | 1639515554 - BRIAN SKAUG | 760459500 - U T PHYSICIANS | TX | Rheumatology Physician (207RR0500X) |
United | J9145 | $87.52 | 1215929518 - LARRY CARPENTER | 741613878 - (TX) BAYLOR COLLEGE OF MEDICINE | TX | Radiation Oncology Physician (2085R0001X) |
United | J9145 | $225.36 | 1215929518 - LARRY CARPENTER | 760386391 - KELSEY-SEYBOLD MEDICAL GROUP PLLC | TX | Radiation Oncology Physician (2085R0001X) |
United | J9145 | $302.04 | 1215929518 - LARRY CARPENTER | 760386391 - KELSEY-SEYBOLD MEDICAL GROUP PLLC | TX | Radiation Oncology Physician (2085R0001X) |
United | J9145 | $72.70 | 1144715384 - MARYAM ELMI | 742915297 - (TX) SOUTH TEXAS ONCOLOGY AND HEMATOLOGY PLLC | TX | Surgical Oncology Physician (2086X0206X) |
United | J9145 | $65.31 | 1437400702 - ALA'A EDDIN TAYYEM | 271371893 - ASCENSION VIA CHRISTI HOSPITAL ST TERESA INC / HOSPITALIST MEDICINE HEALTHCARE LLC / HOSPITALIST MEDICINE PHYSICIANS OF TEXAS PLLC | TX | Medical Oncology Physician (207RX0202X) |
United | J9145 | $189.58 | 1326482860 - ROHAN GUPTA | 274803222 - CITY OF HOPE MEDICAL FOUNDATION | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9145 | $65.31 | 1548242720 - TRIPTESH CHAUDHURY | 760629376 - (TX) GULF COAST ONCOLOGY ASSOCIATES PA | TX | Radiation Oncology Physician (2085R0001X) |
United | J9145 | $89.51 | 1205256047 - BRANDON ROANE | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Gynecologic Oncology Physician (207VX0201X) |
United | J9145 | $72.70 | 1528038759 - SAMER BIBAWI | 752896138 - MEDHEALTH | TX | Medical Oncology Physician (207RX0202X) |
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 J9145 vs. Other Chemotherapy Drugs Codes
The HCPCS J9145 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 J9145 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 |
|---|---|---|
| J9144-HCPCS | Low | Injection, daratumumab, 10 mg and hyaluronidase-fihj |
| J9145-HCPCS | Low | Injection, daratumumab, 10 mg |
| J9150-HCPCS | Low | Injection, daunorubicin, 10 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9145. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9145 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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