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See a sample rate comparisonHCPCS J9216 (Actimmune) Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Injection, interferon, gamma 1-b, 3 million units
| Key Fact | Detail |
|---|---|
| Service Type | Chemotherapy Drugs |
| Common Place of Service | 11 - Office None |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for J9216 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 75987-0111-10 - ACTIMMUNE 2 Million IU/0.5 ML • 75987-0111-11 - ACTIMMUNE 2 MILLION IU/0.5 ML |
National average reimbursement for HCPCS J9216 by major payers:
$7,225.30
$8,644.35
$8,262.87
$5,878.68
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HCPCS J9216
5 of 25 sample ratesHigher to lower in this preview
University Of California Irvine, Uci Medical Center
$38,587.69Published rateSpectrum Heatlh United, United Memorial Hospital Association
Spectrum Health United
$10,876.66Published rateJ. C. Blair Memorial Hospital, Penn Highlands Huntingdon
J C Blair Memorial Hospital
$8,630.63Published rateNational Jewish Health
$8,142.10Published rateCommunity Howard Regional Health, Inc
Community Howard Regional Health Inc
$8,142.10Published rate
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See a sample payer proposalHCPCS J9216 vs. Other Chemotherapy Drugs Codes
The HCPCS J9216 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 J9216 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 |
|---|---|---|
| 75987-0111-10-NDC | Moderate | ACTIMMUNE 2 Million IU/0.5 ML |
| 75987-0111-11-NDC | Moderate | ACTIMMUNE 2 MILLION IU/0.5 ML |
| J9215-HCPCS | Low | Injection, interferon, alfa-N3, (human leukocyte derived), 250, 000 IU |
| J9216-HCPCS | High | Injection, interferon, gamma 1-b, 3 million units |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9216. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9216 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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