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HCPCS J9307 (Folotyn) Fee Schedule

Last Verified: December 2025

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, pralatrexate, 1 mg
Key FactDetail
Service Type

Chemotherapy Drugs

Common Place of Service

None

11 - Office

Complexity LevelModerate
Medicare Payment Limit
$392.629BuyandBill.com
WAC Price
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National average reimbursement for HCPCS J9307 by major payers:

bcbs

$339.97

uhc

$396.87

aetna

$392.29

cigna

$392.68

Preview provider-level rates for...
For billing codeHCPCS J9307
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J9307

United
J9307$373.761356890560 - ANDREW LU113465690NJHematology & Oncology Physician (207RH0003X)
United
J9307$416.071275521361 - JOHN SMITH223837316NJHematology & Oncology Physician (207RH0003X)
United
J9307$416.071578675112 - MICHAEL PEREIRA272777455NJRadiation Oncology Physician (2085R0001X)
United
J9307$396.201316320237 - ASHWIN CHANDAR264203938NJHematology & Oncology Physician (207RH0003X)
United
J9307$384.981114424967 - KRISTINE LACUNA300937486NJMedical Oncology Physician (207RX0202X)
United
J9307$373.761548295306 - SETH COHEN814837197NJMedical Oncology Physician (207RX0202X)
United
J9307$411.141639166101 - JULIANNE CHILDS223141761NJHematology & Oncology Physician (207RH0003X)
United
J9307$395.271770699605 - SUCHA ASBELL232696460NJRadiation Oncology Physician (2085R0001X)
United
J9307$444.791164459079 - BRIAN CHON852303328NJRadiation Oncology Physician (2085R0001X)
United
J9307$373.761407804669 - THE LOWELL GENERAL HOSPITAL, LOWELL GENERAL HOSPITAL42103590 - (MA) THE LOWELL GENERAL HOSPITALMAGeneral Acute Care Hospital (282N00000X)
United
J9307$426.981386690840 - MOHAMAD CHERRY202088165NJHematology & Oncology Physician (207RH0003X)
United
J9307$373.761720025679 - LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER, EARL K LONG MEDICAL CENTER720645546 - (LA) LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTERLAGeneral Acute Care Hospital (282N00000X)
United
J9307$336.391558341735 - STUART LEITNER814786011NJHematology & Oncology Physician (207RH0003X)
United
J9307$373.761568494888 - RACHANA SINGH210634572NJRadiation Oncology Physician (2085R0001X)
United
J9307$416.071417997719 - JAMES DALZELL200333191NJRadiation Oncology Physician (2085R0001X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS J9307 vs. Other Chemotherapy Drugs Codes

The HCPCS J9307 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 J9307 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.

CodeComplexityDescription
J9306-HCPCSLowInjection, pertuzumab, 1 mg
J9307-HCPCSModerateInjection, pralatrexate, 1 mg
J9308-HCPCSLowInjection, ramucirumab, 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 J9307. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J9307 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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