HCPCS J9306 (Perjeta) 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 | |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J9306 by major payers:

$17.66

$17.33

$17.82

$17.08
| 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 J9306 | ||||||
United | J9306 | $22.19 | 1518928514 - ANNA BELCHEVA | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Medical Oncology Physician (207RX0202X) |
United | J9306 | $31.07 | 1639494834 - CHARLES KIMBROUGH | 752536818 - HEALTHTEXAS PROVIDER NETWORK | TX | Surgical Oncology Physician (2086X0206X) |
United | J9306 | $16.19 | 1407058530 - FARIBORZ GOROUHI | 471158090 - (TX) CITIZENS MEDICAL CENTER COUNTY OF VICTORIA | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9306 | $18.62 | 1891733275 - PATIENTS COMPREHENSIVE DIAGNOSTIC & RADIATION CENTER, INC | 760684596 - (TX) PATIENTS COMPREHENSIVE DIAGNOSTIC RADIATION CENTER INC | TX | Radiation Oncology Clinic/Center (261QX0203X) |
United | J9306 | $23.87 | 1700166543 - NITYA GULATI | 131623978 - ANDROLOGY LAB / BRISTOL DIABETES ENDOCRINOLOGY / CARDIOTHORACIC SURGERY PC | TX | Pediatric Hematology & Oncology Physician (2080P0207X) |
United | J9306 | $14.10 | 1114123163 - GLEN BALCH | 582030692 - EMORY UNIVERSITY | TX | Surgical Oncology Physician (2086X0206X) |
United | J9306 | $18.62 | 1164719100 - ALFREDO SARDINAS | 833179743 - (TX) ALFREDO SARDINAS JR MD PA | TX | Rheumatology Physician (207RR0500X) |
United | J9306 | $18.02 | 1205042173 - VIJAY KARIA | 465768681 - (TX) KARIA PHYSICIAN ASSOCIATES PA | TX | Rheumatology Physician (207RR0500X) |
United | J9306 | $16.19 | 1932384450 - BILAL OMER | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Pediatric Hematology & Oncology Physician (2080P0207X) |
United | J9306 | $17.01 | 1598008658 - EISENHOWER MEDICAL CENTER, EISENHOWER | 956130458 - EISENHOWER MEDICAL CENTER | CA | General Acute Care Hospital (282N00000X) |
United | J9306 | $18.02 | 1346355435 - KARL KING | 831864463 | TX | Radiation Oncology Physician (2085R0001X) |
United | J9306 | $31.07 | 1215139027 - BINU NAIR | 752536818 - HEALTHTEXAS PROVIDER NETWORK | TX | Hematology & Oncology Physician (207RH0003X) |
United | J9306 | $22.19 | 1437108081 - ENRIQUE PEREZ | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Medical Oncology Physician (207RX0202X) |
United | J9306 | $16.19 | 1164789137 - CASEY MCATEE | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Pediatric Hematology & Oncology Physician (2080P0207X) |
United | J9306 | $16.19 | 1619060498 - ROY HERBST | 60646973 - YALE UNIVERSITY | TX | Medical Oncology Physician (207RX0202X) |
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 J9306 vs. Other Chemotherapy Drugs Codes
The HCPCS J9306 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 J9306 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 |
|---|---|---|
| J9305-HCPCS | Low | Injection, pemetrexed, not otherwise specified, 10 mg |
| J9306-HCPCS | Low | Injection, pertuzumab, 1 mg |
| J9307-HCPCS | Moderate | Injection, pralatrexate, 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 J9306. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9306 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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