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See a sample rate comparisonHCPCS J9325 (Imlygic) Fee Schedule
Last Verified: October 2026
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, talimogene laherparepvec, per 1 million plaque forming units
| Key Fact | Detail |
|---|---|
| Service Type | Chemotherapy Drugs |
| Common Place of Service | None 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J9325 |
| Medicare Payment Limit | $73.935  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J9325 by major payers:
$74.02
$75.22
$75.78
$74.48
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HCPCS J9325
5 of 25 sample ratesHigher to lower in this preview
Aroostook Medical Center, Northern Light A.R. Gould Hospital
Eastern Maine Healthcare Systems
$123.12Published rateCommunity Hospital Of Anderson & Madison County, Inc
Community Hospital Of Anderson- Madison County Inc
$78.33Published rateEisenhower Medical Center, Eisenhower
Eisenhower Medical Center
$73.91Published rateSarah Easaw
$70.37Published rateHenry County Memorial Hospital
$70.33Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J9325 vs. Other Chemotherapy Drugs Codes
The HCPCS J9325 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 J9325 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 |
|---|---|---|
| J9323-HCPCS | Low | Injection, pemetrexed ditromethamine, 10 mg |
| J9325-HCPCS | Low | Injection, talimogene laherparepvec, per 1 million plaque forming units |
| J9328-HCPCS | Low | Injection, temozolomide, 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 J9325. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9325 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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