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See a sample rate comparisonHCPCS J9262 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, omacetaxine mepesuccinate, 0.01 mg
| Key Fact | Detail |
|---|---|
| Service Type | Chemotherapy Drugs |
| Common Place of Service | None 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J9262 |
National average reimbursement for HCPCS J9262 by major payers:
$4.17
$4.85
$4.66
$4.11
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HCPCS J9262
5 of 25 sample ratesHigher to lower in this preview
Ascension Via Christi Hospital Pittsburg, Inc., Mt. Carmel Regional Medical Center, Inc.
Ascension Via Christi Hospital Pittsburg Inc
$8.27Published rateSeth Cohen
$5.03Published rateDavid Sharon
$4.55Published rateMichael Chang
$4.55Published rateSoutheast Health Center Of Stoddard County, LLC, Mercy Hospital Stoddard
Southeast Health Center Of Stoddard County LLC
$3.95Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J9262 vs. Other Chemotherapy Drugs Codes
The HCPCS J9262 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 J9262 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 |
|---|---|---|
| J9261-HCPCS | Low | Injection, nelarabine, 50 mg |
| J9262-HCPCS | Low | Injection, omacetaxine mepesuccinate, 0.01 mg |
| J9263-HCPCS | Low | Injection, oxaliplatin, 0.5 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9262. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9262 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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