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See a sample rate comparisonHCPCS J9393 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, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg
| Key Fact | Detail |
|---|---|
| Service Type | Chemotherapy Drugs |
| Common Place of Service | 11 - Office None 99 - Other POS |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J9393 |
National average reimbursement for HCPCS J9393 by major payers:
$33.31
$22.14
$21.21
$15.46
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HCPCS J9393
5 of 25 sample ratesHigher to lower in this preview
Filippo Filicori
North Shore-Lij Medical PC
$30.89Published rateRobert Alter
$22.65Published rateSouth Jersey Radiation Oncology P.C.
$20.60Published rateTiffany Pompa
$20.60Published rateMonmouth Medical Center Inc, Monmouth Medical Center Southern Campus
$2.73Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J9393 vs. Other Chemotherapy Drugs Codes
The HCPCS J9393 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 J9393 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 |
|---|---|---|
| J9390-HCPCS | Low | Injection, vinorelbine tartrate, 10 mg |
| J9393-HCPCS | Low | Injection, fulvestrant (teva), not therapeutically equivalent to j9395, 25 mg |
| J9394-HCPCS | Low | Injection, fulvestrant (fresenius kabi) not therapeutically equivalent to j9395, 25 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J9393. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J9393 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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