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HCPCS J9381 (Tzield) 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, teplizumab-mzwv, 5 mcg
Key FactDetail
Service Type

Chemotherapy Drugs

Common Place of Service

None

11 - Office

Complexity LevelLow
Medicare Payment Limit
$37.662BuyandBill.com
WAC Price
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Related NDC Codes

73650-0316-01 - TZIELD (SDV,PF) 1 MG/1 ML

73650-0316-10 - TZIELD (SDV,PF) 1 MG/1 ML

73650-0316-14 - TZIELD (SDV,PF) 1 MG/1 ML


National average reimbursement for HCPCS J9381 by major payers:

bcbs

$38.97

uhc

$37.69

aetna

$41.16

cigna

$39.05

Preview provider-level rates for...
For billing codeHCPCS J9381
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J9381

United
J9381$37.241548295306 - SETH COHEN222362154NJMedical Oncology Physician (207RX0202X)
United
J9381$37.271164463493 - SAINT FRANCIS MEDICAL CENTER, OUTPATIENT SERVICES370662569 - (IL) SAINT FRANCIS MEDICAL CENTERILGeneral Acute Care Hospital (282N00000X)
United
J9381$36.901508898594 - SHAILJA ROY210660835NJHematology & Oncology Physician (207RH0003X)
United
J9381$37.811871936898 - PAYAL SONI20543270NJRadiation Oncology Physician (2085R0001X)
United
J9381$36.901700880069 - JONATHAN BRIGGS823157047NJRadiation Oncology Physician (2085R0001X)
United
J9381$66.051558814657 - MSK BERGEN611791803NJMedical Oncology Physician (207RX0202X)
United
J9381$65.021992142046 - WILLIAM RAFELSON300937486NJHematology & Oncology Physician (207RH0003X)
United
J9381$37.241255300141 - RICHARDS AFONJA421634032NJHematology & Oncology Physician (207RH0003X)
United
J9381$36.951730299041 - DAVID SHARON814837197NJHematology & Oncology Physician (207RH0003X)
United
J9381$37.241417364456 - KRISTINE BADIN841759969NJHematology & Oncology Physician (207RH0003X)
United
J9381$37.241477865426 - MEGAN MEZERA223587486NJRadiation Oncology Physician (2085R0001X)
United
J9381$37.241114248002 - JOEL ALCID852303328NJHematology & Oncology Physician (207RH0003X)
United
J9381$33.201356442602 - PATRICK LEE454832340NJHematology (Internal Medicine) Physician (207RH0000X)
United
J9381$34.311396947503 - EMILY CHEN810889110NJHematology & Oncology Physician (207RH0003X)
United
J9381$38.001114424967 - KRISTINE LACUNA300937486NJMedical Oncology Physician (207RX0202X)
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 J9381 vs. Other Chemotherapy Drugs Codes

The HCPCS J9381 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 J9381 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
73650-0316-01-NDCModerateTZIELD (SDV,PF) 1 MG/1 ML
73650-0316-10-NDCModerateTZIELD (SDV,PF) 1 MG/1 ML
73650-0316-14-NDCModerateTZIELD (SDV,PF) 1 MG/1 ML
J9381-HCPCSLowInjection, teplizumab-mzwv, 5 mcg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9381. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J9381 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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