HCPCS J9313 (Lumoxiti) 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 |
| Complexity Level | Low |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J9313 by major payers:
$24.73
$24.36
$24.40
$24.03
| 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 J9313 | ||||||
United | J9313 | $27.34 | 1427536325 - UNIVERSITY HEALTH SHREVEPORT LLC, OCHSNER LSU HEALTH SHREVEPORT | 831173631 | LA | General Acute Care Hospital (282N00000X) |
United | J9313 | $22.72 | 1548558125 - YAN CHENG | 223680355 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9313 | $25.00 | 1811104292 - ETHAN WASSERMAN | 223141761 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9313 | $25.29 | 1023337722 - PRASHANT DESAI | 463483967 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9313 | $25.00 | 1063403509 - CRAIG LAMPERT | 852303328 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9313 | $24.09 | 1568454080 - NEIL MORGANSTEIN | 221919006 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9313 | $25.00 | 1972746394 - LORI LESLIE | 223141761 | NJ | Medical Oncology Physician (207RX0202X) |
United | J9313 | $22.72 | 1568411908 - CLARISSA HENSON | 460961495 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9313 | $23.37 | 1326546797 - HENDERSON HOSPITAL, LLC, UTHEALTH EAST TEXAS HENDERSON HOSPITAL | 824019349 | TX | General Acute Care Hospital (282N00000X) |
United | J9313 | $25.00 | 1063480010 - HENRY TSAI | 852303328 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9313 | $20.45 | 1356890560 - ANDREW LU | 113465690 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9313 | $25.00 | 1578563334 - JOSEPH FANELLE | 820947698 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9313 | $26.47 | 1841243771 - VALLEY RADIATION ONCOLOGY ASSOC PA | 223147770 | NJ | Radiation Oncology Physician (2085R0001X) |
United | J9313 | $21.13 | 1982695086 - ERICA LINDEN | 810889110 | NJ | Hematology & Oncology Physician (207RH0003X) |
United | J9313 | $22.72 | 1104870450 - GOPAL DESAI | 222405291 | NJ | Radiation Oncology Physician (2085R0001X) |
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 J9313 vs. Other Chemotherapy Drugs Codes
The HCPCS J9313 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 J9313 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 |
|---|---|---|
| J9312-HCPCS | Low | Injection, rituximab, 10 mg |
| J9313-HCPCS | Low | Injection, moxetumomab pasudotox-tdfk, 0.01 mg |
| J9314-HCPCS | Low | Injection, pemetrexed (teva) 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 J9313. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9313 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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