HCPCS J9299 (Opdivo) 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 | $32.964  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00003-3734-13 - OPDIVO (PF) 10 MG/1 ML • 00003-3756-14 - OPDIVO (PF) 10 MG/1 ML • 00003-3772-11 - OPDIVO (PF) 10 MG/ML |
National average reimbursement for HCPCS J9299 by major payers:
$35.26
$34.05
$35.70
$33.72
| 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 J9299 | ||||||
United | J9299 | $33.50 | 1174624282 - VINCENT KAROLEWICS | 631196960 - (AL) CULLMAN RADIATION THERAPY SERV | AL | Radiation Oncology Physician (2085R0001X) |
United | J9299 | $33.65 | 1902989189 - ANTHONY KALLIATH | 630897317 - ONCOLOGY SPECIALTIES, P.C. | AL | Hematology & Oncology Physician (207RH0003X) |
United | J9299 | $23.93 | 1750376703 - RONALD JOHNS | 30450840 - AMY VAN DORFY M D P A | TX | Internal Medicine Physician (207R00000X) |
United | J9299 | $31.09 | 1629004478 - MARK SHIU | 934319739 | CA | Family Medicine Physician (207Q00000X) |
United | J9299 | $33.91 | 1144622143 - SANGAMESHWAR P REDDY MD PA | 205575060 - SANGAMESHWAR P REDDY MD PA | TX | Multi-Specialty Group (193200000X) |
United | J9299 | $33.30 | 1497775696 - JOHN HAYNES | 352526373 - ACCLAIM PHYSICIAN GROUP INC | TX | Family Medicine Physician (207Q00000X) |
United | J9299 | $37.61 | 1720389919 - YVONNE RODRIGUEZ | 271504911 - (CA) MEMORIALCARE MEDICAL FOUNDATION | CA | Family Medicine Physician (207Q00000X) |
United | J9299 | $31.09 | 1477968428 - MOHAMMAD ABDULLAH | 812073947 - CARBON HEALTH MEDICAL GROUP, INC. | CA | Family Medicine Physician (207Q00000X) |
United | J9299 | $32.96 | 1902238389 - BARBARA REEVES | 920763412 - PALLIATIVE CARE OF EL PASO | TX | Family Medicine Physician (207Q00000X) |
United | J9299 | $64.16 | 1558314096 - WAKANA SAEKI | 814542216 - (CA) PROVIDENCE SAINT JOHNS MEDICAL FOUNDATION | CA | Family Medicine Physician (207Q00000X) |
United | J9299 | $30.46 | 1174507313 - SENTAYEHU KASSA | 756004221 - DALLAS COUNTY HOSPITAL DISTRICT | TX | Family Medicine Physician (207Q00000X) |
United | J9299 | $32.95 | 1932467792 - TEJA POOSARLA | 871010407 - (AL) USA HEALTH | AL | Medical Oncology Physician (207RX0202X) |
United | J9299 | $108.23 | 1306801766 - TIMOTHY BULLARD | 954373071 | CA | Family Medicine Physician (207Q00000X) |
United | J9299 | $33.91 | 1003024746 - KERRI BEVIS | 636000526 - (AL) EAST ALABAMA MEDICAL CENTER | AL | Gynecologic Oncology Physician (207VX0201X) |
United | J9299 | $32.25 | 1124489604 - UNIVERSITY OF SOUTH ALABAMA, USA HEMATOLOGY & ONCOLOGY- PEDIATRICS | 630477348 - (AL) UNIVERSITY OF SOUTH ALABAMA | AL | Pediatric Hematology & Oncology Physician (2080P0207X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
HCPCS J9299 vs. Other Chemotherapy Drugs Codes
The HCPCS J9299 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 J9299 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 |
|---|---|---|
| 00003-3734-13-NDC | Moderate | OPDIVO (PF) 10 MG/1 ML |
| J9298-HCPCS | Moderate | Injection, nivolumab and relatlimab-rmbw, 3 mg/1 mg |
| J9299-HCPCS | Low | Injection, nivolumab, 1 mg |
| J9301-HCPCS | Low | Injection, obinutuzumab, 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 J9299. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9299 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS J9299) and we'll show you how you compare in 15 minutes or less.