HCPCS J0873

Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or j0872, 1 mg

Current code9 hospitals with prices

Description from CMS's HCPCS Level II code file.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for HCPCS J0873 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
Cascade Valley HospitalArlington	$1241 plan	$99.54	$124
EvergreenHealth Medical CenterKirkland	—	$114	$143
EvergreenHealth MonroeMonroe	—	$287	$359
PeaceHealth Peace Island Medical CenterFriday Harbor	—	$131 – $131	$201 – $202
PeaceHealth Southwest Medical CenteVancouver	—	$131 – $131	$201 – $202
PeaceHealth St John Medical CenterLongview	—	$131 – $131	$201 – $202
PeaceHealth St Joseph Medical CenterBellingham	—	$131 – $131	$201 – $202
PeaceHealth United General Medical CenterSedro Woolley	—	$131 – $131	$201 – $202
Skagit Valley HospitalMount Vernon	—	$99.54	$124

Lowest and highest amounts each hospital lists for this code as an outpatient, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

CMS publishes no national amount for this code.