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HCPCS J9261 (Arranon) Fee Schedule

Last Verified: November 2025

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, nelarabine, 50 mg
Key FactDetail
Service Type

Chemotherapy Drugs

Common Place of Service

None

11 - Office

99 - Other POS

Complexity LevelLow
Medicare Payment Limit
$79.862BuyandBill.com
WAC Price
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Related NDC Codes

00078-0683-61 - ARRANON (LATEX-FREE) 5 MG/1 ML

25021-0259-50 - NELARABINE SDV 5 MG/1 ML

25021-0259-51 - NELARABINE SDV 5 MG/1 ML

39822-0650-01 - NELARABINE SDV 5 MG/1 ML

39822-0650-06 - NELARABINE SDV 5 MG/1 ML


National average reimbursement for HCPCS J9261 by major payers:

bcbs

$85.79

uhc

$82.01

aetna

$91.37

cigna

$80.11

Preview provider-level rates for...
For billing codeHCPCS J9261
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J9261

United
J9261$76.871477554418 - GLENDA SMITH205745047NJRadiation Oncology Physician (2085R0001X)
United
J9261$82.231538139548 - EDWARD LICITRA852303328NJHematology & Oncology Physician (207RH0003X)
United
J9261$83.221558317149 - RAJESH IYER223444048NJRadiation Oncology Physician (2085R0001X)
United
J9261$74.761043301641 - BARRY LEVINSON237293874NJHematology & Oncology Physician (207RH0003X)
United
J9261$85.971306887245 - TAMI BACH221929064NJHematology & Oncology Physician (207RH0003X)
United
J9261$76.871548715998 - JOSEPH HO222306123NJHematology & Oncology Physician (207RH0003X)
United
J9261$78.871053413500 - DAVID GREENBERG223376459NJHematology & Oncology Physician (207RH0003X)
United
J9261$69.521205897808 - DAVID HORVICK810889110NJRadiation Oncology Physician (2085R0001X)
United
J9261$72.691578872776 - STEPHAN DORKHOM222810004NJHematology & Oncology Physician (207RH0003X)
United
J9261$81.621538145123 - JOSEPH LATTANZI223444048NJRadiation Oncology Physician (2085R0001X)
United
J9261$82.981205192747 - WILLIAM GREEN232743545NJRadiation Oncology Physician (2085R0001X)
United
J9261$87.471851522197 - RUJUTA SAKSENA510384913NJHematology & Oncology Physician (207RH0003X)
United
J9261$79.251700878840 - J. C. BLAIR MEMORIAL HOSPITAL, PENN HIGHLANDS HUNTINGDON251881378PAGeneral Acute Care Hospital (282N00000X)
United
J9261$103.161700144706 - QI RONG522228444MDGeneral Acute Care Hospital (282N00000X)
United
J9261$98.051497984330 - OKSANA YASKIV453023019 - (NY) NORTH SHORE-LIJ MEDICAL PCMOGeneral Acute Care Hospital (282N00000X)
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 J9261 vs. Other Chemotherapy Drugs Codes

The HCPCS J9261 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 J9261 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
00078-0683-61-NDCModerateARRANON (LATEX-FREE) 5 MG/1 ML
J9260-HCPCSLowMethotrexate sodium, 50 mg
J9261-HCPCSLowInjection, nelarabine, 50 mg
J9262-HCPCSLowInjection, omacetaxine mepesuccinate, 0.01 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9261. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J9261 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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