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See a sample rate comparisonHCPCS J9201 (Gemcitabine) 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, gemcitabine hydrochloride, not otherwise specified, 200 mg
| Key Fact | Detail |
|---|---|
| Service Type | Chemotherapy Drugs |
| Common Place of Service | None 11 - Office 22 - On Campus Outpatient Hospital |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J9201 |
| Medicare Payment Limit | $3.128  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 16714-0909-01 - GEMCITABINE (PF,LATEX-FREE) 200 MG • 16714-0930-01 - GEMCITABINE (PF,LATEX-FREE) 1 GM • 25021-0234-10 - GEMCITABINE HCL (SDV,USP,PF,LYOPHILIZED) 200 MG • 25021-0235-50 - GEMCITABINE HCL (SDV,USP,PF,LYOPHILIZED) 1 GM • 25021-0235-51 - GEMCITABINE HCL (SDV,USP,PF,LYOPHILIZED) 1 GM |
National average reimbursement for HCPCS J9201 by major payers:
$3.82
$9.52
$8.22
$4.68
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HCPCS J9201
5 of 25 sample ratesHigher to lower in this preview
Tejash Patel
Kelsey-Seybold Medical Group PLLC
$61.16Published rateDay Kimball Healthcare, Inc.
Day Kimball Healthcare Inc
$16.44Published rateJared Cohen
Ssm Health Care Group
$3.42Published rateRohit Venkatesan
$2.86Published rateNew York City Health And Hospitals Corporation, Woodhull Medical & Mental Health Center
New York City Health And Hospitals Corporation
$2.19Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J9201 vs. Other Chemotherapy Drugs Codes
The HCPCS J9201 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 J9201 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 |
|---|---|---|
| 16714-0909-01-NDC | Moderate | GEMCITABINE (PF,LATEX-FREE) 200 MG |
| 16714-0930-01-NDC | Moderate | GEMCITABINE (PF,LATEX-FREE) 1 GM |
| 25021-0234-10-NDC | Moderate | GEMCITABINE HCL (SDV,USP,PF,LYOPHILIZED) 200 MG |
| J9201-HCPCS | Low | Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9201. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9201 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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