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HCPCS S0122 (Menopur) 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, menotropins, 75 IU
Key FactDetail
Service Type

Temporary National Codes (Non-Medicare)

Non-Medicare Drug Codes

Common Place of Service

11 - Office

19 - Off Campus Outpatient Hospital

None

Complexity LevelModerate
Medicaid Fee ScheduleView Medicaid rates for S0122
WAC Price
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National average reimbursement for HCPCS S0122 by major payers:

bcbs

$224.47

uhc

$247.64

aetna

$245.53

cigna

$192.95

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS S0122.

HCPCS S0122
5 of 25 sample ratesHigher to lower in this preview
  1. Wella Augustine

    Slocum Orthopedics PC

    ORPhysical TherapistNPI 1265415624Tax ID 93-0603212

    $303.44Published rate
  2. Travis Hoffman

    Willamette Community Health Solutions

    OROccupational TherapistNPI 1033388137Tax ID 93-0421470

    $242.75Published rate
  3. Leif Meyers

    Doctors Emergency Room Corp PC

    MIEmergency Medicine PhysicianNPI 1225257801Tax ID 93-0593500

    $242.75Published rate
  4. Pamela Cotton

    Doctors Emergency Room Corp PC

    ORFamily Nurse PractitionerNPI 1720590987Tax ID 93-0593500

    $242.75Published rate
  5. Kyle Kurzet

    Planned Parenthood Of Southwestern Oregon

    ORFamily Medicine PhysicianNPI 1386909851Tax ID 93-0573822

    $242.75Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS S0122 vs. Other Non-Medicare Drug Codes Codes

The HCPCS S0122 code is part of the Temporary National Codes (Non-Medicare) services used for Non-Medicare Drug Codes. 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 S0122 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
S0119-HCPCSLowOndansetron, oral, 4 mg (for circumstances falling under the Medicare statute, use HCPCS Q code)
S0122-HCPCSModerateInjection, menotropins, 75 IU
S0126-HCPCSModerateInjection, follitropin alfa, 75 IU

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S0122. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the S0122 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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