J7999 — Compounded drug, not otherwise classified

What the market charges

Across 702 negotiated rates, the middle 80% fall between $30 and $82, with a median of $55.

What Medicare pays

Medicare allowed an average of $130 for this code, across 267,640.3 services billed by 1,294 providers. At the median, the market charges less than Medicare pays for this code — 58% less.

Where this is billed, and what it costs there

The states billing J7999 most, by Medicare service volume, each compared against the national average of $130. Each links to the providers Mishe lists there.

  • California — 243 providers billed it, Medicare allowed $201 — 55% above the national average
  • Florida — 191 providers billed it, Medicare allowed $86 — 34% below the national average
  • Pennsylvania — 101 providers billed it, Medicare allowed $188 — 45% above the national average
  • Arizona — 46 providers billed it, Medicare allowed $94 — 28% below the national average
  • Texas — 162 providers billed it, Medicare allowed $101 — 22% below the national average
  • Oregon — 51 providers billed it, Medicare allowed $92 — 29% below the national average
  • New Jersey — 49 providers billed it, Medicare allowed $87 — 33% below the national average
  • Washington — 52 providers billed it, Medicare allowed $91 — 30% below the national average

Deploy this for your team

Every figure on this page came from published payer and Medicare data, assembled by Mishe. The same pricing, claim-editing and care-pathway intelligence runs underneath the plans Mishe operates.

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