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HCPCS J9185 (Fludarabine Phosphate) 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, fludarabine phosphate, 50 mg
Key FactDetail
Service Type

Chemotherapy Drugs

Common Place of Service

None

11 - Office

22 - On Campus Outpatient Hospital

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for J9185
Medicare Payment Limit
$68.197BuyandBill.com
WAC Price
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Related NDC Codes

• 25021-0242-02 - FLUDARABINE PHOSPHATE (1X2ML,SDV,USP,PF) 25 MG/1 ML

• 45963-0609-55 - FLUDARABINE PHOSPHATE (USP,SDV,PF,LYOPHILIZED) 50 MG

• 59923-0604-02 - FLUDARABINE PHOSPHATE (1X2ML;SDV;USP) 25 MG/1 ML


National average reimbursement for HCPCS J9185 by major payers:

bcbs

$148.11

uhc

$159.43

aetna

$149.87

cigna

$143.74

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J9185.

HCPCS J9185
5 of 25 sample ratesHigher to lower in this preview
  1. Allina Health System, Mercy Hospital

    Allina Health System

    MNGeneral Acute Care HospitalNPI 1316904287Tax ID 36-3261413

    $432.82Published rate
  2. Matthew Garrett

    NJRadiation Oncology PhysicianNPI 1821594755Tax ID 20-1104758

    $187.35Published rate
  3. Imraan Jan

    NJRadiation Oncology PhysicianNPI 1306337175Tax ID 22-3371727

    $168.30Published rate
  4. Tami Bach

    NJHematology & Oncology PhysicianNPI 1306887245Tax ID 23-2865181

    $148.91Published rate
  5. Mark Levin

    NJHematology & Oncology PhysicianNPI 1912932765Tax ID 22-3837316

    $87.19Published rate

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

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HCPCS J9185 vs. Other Chemotherapy Drugs Codes

The HCPCS J9185 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 J9185 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
25021-0242-02-NDCModerateFLUDARABINE PHOSPHATE (1X2ML,SDV,USP,PF) 25 MG/1 ML
45963-0609-55-NDCModerateFLUDARABINE PHOSPHATE (USP,SDV,PF,LYOPHILIZED) 50 MG
59923-0604-02-NDCModerateFLUDARABINE PHOSPHATE (1X2ML;SDV;USP) 25 MG/1 ML
J9185-HCPCSLowInjection, fludarabine phosphate, 50 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9185. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J9185 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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