HCPCS J9178 (Ellence) 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 |
| Medicare Payment Limit | $2.112  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00009-5091-01 - ELLENCE (S.D.V.,PF) 2 MG/ML • 00009-5091-25 - ELLENCE SDV; ONCO-TAIN 2 MG/1 ML • 00009-5093-01 - ELLENCE (S.D.V.,PF) 2 MG/ML • 00009-5093-10 - ELLENCE SDV; ONCO-TAIN 2 MG/1 ML |
National average reimbursement for HCPCS J9178 by major payers:
$1.77
$1.90
$1.87
$1.84
| 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 J9178 | ||||||
United | J9178 | $1.62 | 1881865046 - CARDIOLOGY & ONCOLOGY ASSOC., P.A. | 223144262 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9178 | $1.62 | 1184707234 - SALMA JABBOUR | 223371727 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9178 | $2.01 | 1023428273 - ADAM ZAYAC | 264709927 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9178 | $1.72 | 1841453263 - SHEETAL SHRIMANKER | 264203938 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9178 | $1.47 | 1962504936 - STEFAN BALAN | 454832340 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9178 | $1.62 | 1518904929 - RUTGERS HEALTH-RWJ SCLERODERMA PROGRAM, RUTGERS HEALTH- RWJ CANCER INSTITUTE OF NEW JERSEY | 223371727 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9178 | $1.77 | 1518165919 - AAMER FAROOQ | 852303328 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9178 | $1.80 | 1245349638 - MUHAMMAD ABBASI | 222132567 | NJ | Hematology (Internal Medicine) Physician (207RH0000X) |
United | J9178 | $1.62 | 1356890560 - ANDREW LU | 113465690 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9178 | $1.80 | 1598787640 - ANTHONY BOTTI | 223084389 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9178 | $2.84 | 1093192692 - ZUNAIRA CHOUDHARY | 815309615 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9178 | $1.72 | 1750432720 - RAGHU KUNAMNENI | 223376459 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9178 | $2.77 | 1134194038 - CHRISTIANA CARE HEALTH SERVICES, INC., CHRISTIANA CARE | 510103684 - CHRISTIANA CARE HEALTH SERVICES INC | DE | General Acute Care Hospital (282N00000X) |
United | J9178 | $1.54 | 1083785042 - SHIRNETT WILLIAMSON | 810889110 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9178 | $1.72 | 1033108782 - BRUCE HAFFTY | 222810004 | 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 J9178 vs. Other Chemotherapy Drugs Codes
The HCPCS J9178 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 J9178 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 |
|---|---|---|
| 00009-5091-01-NDC | Moderate | ELLENCE (S.D.V.,PF) 2 MG/ML |
| J9177-HCPCS | Low | Injection, enfortumab vedotin-ejfv, 0.25 mg |
| J9178-HCPCS | Low | Injection, epirubicin HCl, 2 mg |
| J9179-HCPCS | Low | Injection, eribulin mesylate, 0.1 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9178. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9178 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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