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See a sample rate comparisonHCPCS J9264 (Abraxane) 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, paclitaxel protein-bound particles, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Chemotherapy Drugs |
| Common Place of Service | None 11 - Office 22 - On Campus Outpatient Hospital |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J9264 |
| Medicare Payment Limit | $10.543  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00480-3290-01 - PACLITAXEL PROTEIN-BOUND PARTICLES (ALBUMIN-BOUND) 100 MG • 00517-4300-01 - PACLITAXEL PROTEIN-BOUND PARTICLES ALBUMIN-BOUND,LYOPHILIZED 100 MG • 00781-3531-91 - PACLITAXEL PROTEIN-BOUND PARTICLES ALBUMIN-BOUND,LYOPHILIZED 100 MG • 60505-6230-04 - PACLITAXEL PROTEIN-BOUND PARTICLES 100 MG • 68001-0651-37 - PACLITAXEL PROTEIN-BOUND PARTICLES ALBUMIN-BOUND,LYOPHILIZED 100 MG |
National average reimbursement for HCPCS J9264 by major payers:
$14.83
$14.53
$14.92
$14.15
Compare published rates across providers.
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HCPCS J9264
5 of 25 sample ratesHigher to lower in this preview
Paul Gonzales
Carris Health LLC
$29.23Published rateJulie Nangia
Baylor College Of Medicine / Contemporary Medicine Associates PLLC / St Lukes Community Development Corporation
$18.13Published rateTahir Rana
Denton Cancer Center PLLC / North Texas Cancer Center Lp
$15.06Published rateSamantha Shapiro
Beth Israel Deaconess Medical Center Inc
$13.53Published rateAlexander Lazarides
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
$12.06Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J9264 vs. Other Chemotherapy Drugs Codes
The HCPCS J9264 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 J9264 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 |
|---|---|---|
| 00480-3290-01-NDC | Moderate | PACLITAXEL PROTEIN-BOUND PARTICLES (ALBUMIN-BOUND) 100 MG |
| 00517-4300-01-NDC | Moderate | PACLITAXEL PROTEIN-BOUND PARTICLES ALBUMIN-BOUND,LYOPHILIZED 100 MG |
| 00781-3531-91-NDC | Moderate | PACLITAXEL PROTEIN-BOUND PARTICLES ALBUMIN-BOUND,LYOPHILIZED 100 MG |
| J9264-HCPCS | Low | Injection, paclitaxel protein-bound particles, 1 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9264. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9264 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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