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See a sample rate comparisonHCPCS S0126 (Gonal F Rff Redi Ject) 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, follitropin alfa, 75 IU
| Key Fact | Detail |
|---|---|
| Service Type | Temporary National Codes (Non-Medicare) Non-Medicare Drug Codes |
| Common Place of Service | None 11 - Office 99 - Other POS |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for S0126 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS S0126 by major payers:
$222.51
$244.42
$258.81
$195.04
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HCPCS S0126
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$507.17Published rateRichard Abraham
Omhc LLC
$241.50Published rateJulia O'Neil
Willamette Community Health Solutions
$241.50Published rateJulie Staub
Willamette Community Health Solutions
$241.50Published rateKatherine Schoonover
Willamette Community Health Solutions
$241.50Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS S0126 vs. Other Non-Medicare Drug Codes Codes
The HCPCS S0126 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 S0126 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 |
|---|---|---|
| S0122-HCPCS | Moderate | Injection, menotropins, 75 IU |
| S0126-HCPCS | Moderate | Injection, follitropin alfa, 75 IU |
| S0128-HCPCS | Low | Injection, follitropin beta, 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 S0126. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S0126 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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