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HCPCS J9202 (Zoladex) 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.

Goserelin acetate implant, per 3.6 mg
Key FactDetail
Service Type

Chemotherapy Drugs

Common Place of Service

None

11 - Office

22 - On Campus Outpatient Hospital

Complexity LevelModerate
Medicaid Fee ScheduleView Medicaid rates for J9202
Medicare Payment Limit
$733.665BuyandBill.com
WAC Price
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Related NDC Codes

• 70720-0950-36 - ZOLADEX (SAFESYSTEM SRN) 3.6 MG

• 70720-0951-30 - ZOLADEX (SAFESYSTEM SRN) 10.8 MG


National average reimbursement for HCPCS J9202 by major payers:

bcbs

$616.61

uhc

$736.40

aetna

$748.63

cigna

$715.81

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J9202.

HCPCS J9202
5 of 25 sample ratesHigher to lower in this preview
  1. Lahey Clinic Hospital, Inc.

    Lahey Clinic Hospital Inc

    MAGeneral Acute Care HospitalNPI 1558392563Tax ID 42-704686

    $979.51Published rate
  2. Carl Minniti

    NJHematology & Oncology PhysicianNPI 1811993652Tax ID 22-1929064

    $775.98Published rate
  3. James Orsini

    NJHematology & Oncology PhysicianNPI 1922084185Tax ID 45-4832340

    $703.05Published rate
  4. Texas Health Harris Methodist Hospital Fort Worth

    TXGeneral Acute Care HospitalNPI 1336172105Tax ID 75-6001743

    $674.77Published rate
  5. Simon Badin

    NJHematology & Oncology PhysicianNPI 1467699405Tax ID 22-2616015

    $562.45Published rate

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

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HCPCS J9202 vs. Other Chemotherapy Drugs Codes

The HCPCS J9202 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 J9202 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
70720-0950-36-NDCModerateZOLADEX (SAFESYSTEM SRN) 3.6 MG
70720-0951-30-NDCModerateZOLADEX (SAFESYSTEM SRN) 10.8 MG
J9201-HCPCSLowInjection, gemcitabine hydrochloride, not otherwise specified, 200 mg
J9202-HCPCSModerateGoserelin acetate implant, per 3.6 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9202. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J9202 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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