Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS J9356 (Herceptin Hylecta) 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, trastuzumab, 10 mg and Hyaluronidase-oysk
| Key Fact | Detail |
|---|---|
| Service Type | Chemotherapy Drugs |
| Common Place of Service | None 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J9356 |
| Medicare Payment Limit | $61.436  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 50242-0077-01 - HERCEPTIN HYLECTA (PF) 10000 U/5 ML-600 MG/5 ML |
National average reimbursement for HCPCS J9356 by major payers:
$70.43
$69.29
$72.48
$68.01
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS J9356.
HCPCS J9356
5 of 25 sample ratesHigher to lower in this preview
Vivian Cline
Us Oncology Corporate, Inc.
$86.41Published ratePurnima Sravanti Teegavarapu
Baylor College Of Medicine
$84.50Published rateProvidence Health & Services-Wa
$67.62Published rateBilal Omer
Texas Childrens Physician Group
$63.06Published rateJacob Locke
Poplar Bluff Hma Physician Management LLC
$63.06Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS J9356 vs. Other Chemotherapy Drugs Codes
The HCPCS J9356 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 J9356 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 |
|---|---|---|
| 50242-0077-01-NDC | Moderate | HERCEPTIN HYLECTA (PF) 10000 U/5 ML-600 MG/5 ML |
| J9355-HCPCS | Low | Injection, trastuzumab, excludes biosimilar, 10 mg |
| J9356-HCPCS | Low | Injection, trastuzumab, 10 mg and Hyaluronidase-oysk |
| J9357-HCPCS | High | Injection, valrubicin, intravesical, 200 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9356. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9356 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS J9356) and we'll show you how you compare in 15 minutes or less.