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HCPCS J9211 (Idamycin Pfs) Fee Schedule

Last Verified: January 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, idarubicin hydrochloride, 5 mg
Key FactDetail
Service Type

Chemotherapy Drugs

Common Place of Service

None

Complexity LevelLow
Medicare Payment Limit
$36.67BuyandBill.com
WAC Price
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Related NDC Codes

00013-2576-05 - IDAMYCIN PFS (SDV,PF,LATEX-FREE) 1 MG/1 ML

00013-2576-91 - IDAMYCIN PFS (SDV,PF,CYTOSAFE VIAL,PF) 1 MG/ML

00013-2586-10 - IDAMYCIN PFS (GLASS SDV,PF,LATEX-FREE) 1 MG/1 ML

00013-2586-91 - IDAMYCIN PFS (SDV.PF,CYTOSAFE VIAL,PF) 1 MG/ML

00013-2596-20 - IDAMYCIN PFS (GLASS SDV,PF,LATEX-FREE) 1 MG/1 ML


National average reimbursement for HCPCS J9211 by major payers:

bcbs

$51.42

uhc

$56.94

aetna

$53.41

cigna

$52.68

Preview provider-level rates for...
For billing codeHCPCS J9211
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J9211

United
J9211$53.811538615794 - PATRICK FLEMING232865181NJHematology & Oncology Physician (207RH0003X)
United
J9211$52.091467699405 - SIMON BADIN841759969NJHematology & Oncology Physician (207RH0003X)
United
J9211$46.701356442602 - PATRICK LEE814837197NJHematology (Internal Medicine) Physician (207RH0000X)
United
J9211$49.501144454877 - SANDRA LAW331065485 - LEGACY SALMON CREEK HOSPITALWAGeneral Acute Care Hospital (282N00000X)
United
J9211$46.701962451195 - BROOKDALE HOSPITAL MEDICAL CENTER, BROOKDALE EMERGENCY PHYSICIANS ASSOCIATES111631746 - BROOKDALE HOSPITAL MEDICAL CENTERNYGeneral Acute Care Hospital (282N00000X)
United
J9211$51.471801850243 - REGIONAL CANCER CARE ASSOCIATES LLC223141761NJHematology & Oncology Physician (207RH0003X)
United
J9211$62.591720320195 - LARYSA SANCHEZ611661781NJMedical Oncology Physician (207RX0202X)
United
J9211$60.721861771784 - PANKHOORI SARAF223376459NJHematology & Oncology Physician (207RH0003X)
United
J9211$46.791588157895 - GREGORY ALEXANDER461420853NJRadiation Oncology Physician (2085R0001X)
United
J9211$42.431952568248 - SWEE JIAN NGEOW20543270NJHematology & Oncology Physician (207RH0003X)
United
J9211$49.611841385226 - PETER GRAHAM232571699NJMedical Oncology Physician (207RX0202X)
United
J9211$46.701548689763 - MANSI SHAH222336698NJHematology (Internal Medicine) Physician (207RH0000X)
United
J9211$55.681841200706 - EDWARD SOFFEN852303328NJRadiation Oncology Physician (2085R0001X)
United
J9211$49.341588005904 - LARA HATHOUT222810004NJRadiation Oncology Physician (2085R0001X)
United
J9211$45.311043485303 - DAVID D'AMBROSIO454832340NJRadiation Oncology Physician (2085R0001X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS J9211 vs. Other Chemotherapy Drugs Codes

The HCPCS J9211 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 J9211 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
00013-2576-05-NDCModerateIDAMYCIN PFS (SDV,PF,LATEX-FREE) 1 MG/1 ML
00013-2576-91-NDCModerateIDAMYCIN PFS (SDV,PF,CYTOSAFE VIAL,PF) 1 MG/ML
00013-2586-10-NDCModerateIDAMYCIN PFS (GLASS SDV,PF,LATEX-FREE) 1 MG/1 ML
J9211-HCPCSLowInjection, idarubicin hydrochloride, 5 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9211. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J9211 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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