HCPCS J9293 (Mitoxantrone Hcl) Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Chemotherapy Drugs |
| Common Place of Service | • None • 11 - Office • 22 - On Campus Outpatient Hospital |
| Complexity Level | Low |
| Medicare Payment Limit | $23.877  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 61703-0343-18 - MITOXANTRONE (USP,CONCENTRATE,MDV,PF) 2 MG/ML • 61703-0343-65 - MITOXANTRONE (USP,CONCENTRATE,MDV,PF) 2 MG/ML • 61703-0343-66 - MITOXANTRONE (USP,CONCENTRATE,MDV,PF) 2 MG/ML • 63323-0132-10 - MITOXANTRONE (USP,PF,LATEX-FREE) 2 MG/ML • 63323-0132-12 - MITOXANTRONE (USP,PF,LATEX-FREE) 2 MG/ML |
National average reimbursement for HCPCS J9293 by major payers:
$54.22
$60.80
$65.22
$59.78
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS J9293 | ||||||
United | J9293 | $62.63 | 1942576954 - RUI WANG | 611791803 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9293 | $40.20 | 1710371893 - JAMES CORNWALL | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | J9293 | $42.66 | 1063494177 - ST LUKES HOSPITAL OF KANSAS CITY, SAINT LUKE'S HOSPITAL OF KANSAS CITY | 440545297 - ST LUKES HOSPITAL OF KANSAS CITY | MO | General Acute Care Hospital (282N00000X) |
United | J9293 | $60.81 | 1447869854 - MEMORIAL HOSPITAL AT GULFPORT, MEMORIAL SURGERY CENTER OCEAN SPRINGS | 646010232 - (MS) GULFPORT SURGERY CLINIC, LLC | MS | General Acute Care Hospital (282N00000X) |
United | J9293 | $67.70 | 1053345629 - CHIRAG SHAH | 202814225 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9293 | $66.90 | 1003828823 - ELLEN RONNEN | 852303328 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9293 | $64.16 | 1417939810 - WILLIAM LERNER | 223376459 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9293 | $57.77 | 1861782641 - NIKHIL THAKER | 810889110 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9293 | $67.70 | 1346311073 - NOAH LINDENBERG | 821379219 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9293 | $62.63 | 1043606957 - DIANA ROTH O'BRIEN | 133237927 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9293 | $62.63 | 1467695692 - DHWANI PARIKH | 611791803 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9293 | $64.51 | 1205897808 - DAVID HORVICK | 272933884 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9293 | $72.37 | 1144726308 - AMENA MOHIUDDIN | 852303328 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9293 | $49.18 | 1902056021 - NEHA CHAWLA | 210634549 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9293 | $66.90 | 1487776373 - SAMEER DESAI | 852303328 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS J9293 vs. Other Chemotherapy Drugs Codes
The HCPCS J9293 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 J9293 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 |
|---|---|---|
| 61703-0343-18-NDC | Moderate | MITOXANTRONE (USP,CONCENTRATE,MDV,PF) 2 MG/ML |
| J9285-HCPCS | Low | Injection, olaratumab, 10 mg |
| J9293-HCPCS | Low | Injection, mitoxantrone hydrochloride, per 5 mg |
| J9294-HCPCS | Low | Injection, pemetrexed (hospira) not therapeutically equivalent to j9305, 10 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9293. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9293 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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