HCPCS J9181 (Etopophos) 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 • 99 - Other POS |
| Complexity Level | Low |
| Medicare Payment Limit | $0.941  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00015-3404-20 - ETOPOPHOS (S.D.V.) 100 MG • 00143-9376-01 - ETOPOSIDE NOVAPLUS (MDV;USP,LATEX-FREE) 20 MG/1 ML • 00143-9510-01 - ETOPOSIDE (USP, MDV) 20 MG/1 ML • 00143-9511-01 - ETOPOSIDE (USP, MDV) 20 MG/1 ML • 00143-9512-01 - ETOPOSIDE (USP, MDV) 20 MG/1 ML |
National average reimbursement for HCPCS J9181 by major payers:
$1.26
$1.86
$1.54
$1.46
| 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 J9181 | ||||||
United | J9181 | $2.47 | 1164424305 - DOUGLAS COUNTY HOSPITAL, ALOMERE HEALTH | 411410148 - (MN) DOUGLAS COUNTY HOSPITAL | MN | General Acute Care Hospital (282N00000X) |
United | J9181 | $1.45 | 1144632035 - ST CATHERINE HOSPITAL, ST CATHERINE PODIATRY | 611726975 | KS | General Acute Care Hospital (282N00000X) |
United | J9181 | $0.98 | 1740249739 - MAINE COAST REGIONAL HEALTH FACILITIES, NORTHERN LIGHT MAINE COAST HOSPITAL | 10198331 - (ME) MAINE COAST REGIONAL HEALTH FACILI DBA NORTHERN LIGHT MAINE COAST HOS | ME | General Acute Care Hospital (282N00000X) |
United | J9181 | $1.50 | 1245324581 - SATURNINO HERRERA | 270444414 - (NJ) GARDEN STATE HEALTHCARE ASSOCIATES, LLC | NJ | General Acute Care Hospital (282N00000X) |
United | J9181 | $1.45 | 1588668842 - HALIFAX REGIONAL HOSPITAL, INC., SENTARA HALIFAX REGIONAL HOSPITAL | 540648699 - (VA) HALIFAX REGIONAL HOSPITAL INC | VA | General Acute Care Hospital (282N00000X) |
United | J9181 | $3.69 | 1114181062 - UNIVERSITY OF KENTUCKY | 610945743 - (KY) KENTUCKY MEDICAL SERVICES FOUNDATION INC | KY | General Acute Care Hospital (282N00000X) |
United | J9181 | $3.92 | 1700835154 - NASHVILLE VAMC | 620484828 | TN | General Acute Care Hospital (282N00000X) |
United | J9181 | $1.37 | 1306886866 - CRAIG COUNTY HOSPITAL AUTHORITY, CRAIG GENERAL HOSPITAL | 731430157 - (OK) CRAIG COUNTY HOSPITAL AUTHORITY | OK | General Acute Care Hospital (282N00000X) |
United | J9181 | $3.92 | 1770533218 - SEATTLE VAMC | 910565166 | WA | General Acute Care Hospital (282N00000X) |
United | J9181 | $0.98 | 1700886322 - WYCKOFF HEIGHTS MEDICAL CENTER | 111631837 - (NY) WYCKOFF HEIGHTS MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | J9181 | $1.04 | 1982657854 - MOUNT SINAI COMMUNITY FOUNDATION, SINAI MEDICAL GROUP | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | General Acute Care Hospital (282N00000X) |
United | J9181 | $1.12 | 1679678486 - MEMORIAL HOSPITAL FLAGLER INC, ADVENTHEALTH PALM COAST | 592951990 - MEMORIAL HOSPITAL FLAGLER INC | FL | General Acute Care Hospital (282N00000X) |
United | J9181 | $1.84 | 1285175596 - VENKAT SUBRAMANIAM | 61603195 | NY | General Acute Care Hospital (282N00000X) |
United | J9181 | $0.87 | 1285175596 - VENKAT SUBRAMANIAM | 61603195 | NY | General Acute Care Hospital (282N00000X) |
United | J9181 | $1.37 | 1205025475 - MICHAEL G DURAN, MD INC. P.S. | 930430029 - TUALITY HEALTHCARE | OR | 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 |
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HCPCS J9181 vs. Other Chemotherapy Drugs Codes
The HCPCS J9181 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 J9181 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 |
|---|---|---|
| 00015-3404-20-NDC | Moderate | ETOPOPHOS (S.D.V.) 100 MG |
| 00143-9376-01-NDC | Moderate | ETOPOSIDE NOVAPLUS (MDV;USP,LATEX-FREE) 20 MG/1 ML |
| 00143-9510-01-NDC | Moderate | ETOPOSIDE (USP, MDV) 20 MG/1 ML |
| J9181-HCPCS | Low | Injection, etoposide, 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 J9181. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9181 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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