Ondansetron (Zofran) injection, per 1 mg (CPT J2405): what Medicare pays
On a hospital bill, CPT J2405 is the code for: Injection, ondansetron hydrochloride, per 1 mg. Here is what Medicare pays for it, what is billed on average, and how to question the line on your bill.
CPT J2405 at a glance
| Medicare average allowed amount | $0.09 |
|---|---|
| Average amount billed to Medicare | $6.57 |
| Billed vs. allowed | 73.0 times |
| Services in the data | 1,875,351 |
| Setting and year | Office or clinic, national average, 2024 |
What this code is
This code is for the medicine itself, billed per unit. The quantity on the bill tells how many units were charged.
Why your hospital bill can show more
Medicare pays drugs per billing unit, close to their average sales price. Hospitals set their own price per unit, and a hospital bill can show a much higher amount for the same drug. Medicare's amount is not a price the hospital must accept, but it is a fair reference to negotiate.
Common billing problems with CPT J2405
The quantity does not match the dose
Drugs are billed per unit. Check that the number of units matches the dose you were given, and ask for the price per unit.
No code on the line
If your bill shows a total without codes, ask for a fully itemized bill. Without codes, nobody can check the charges.
How to question this charge
- Ask the hospital for a fully itemized bill, with the code, date, quantity and price of every line.
- Compare the line with the Medicare amount above.
- Ask in writing for a fair price, the lowest amount they will accept, and any discount for paying in full or for patients without insurance.
- Ask for the hospital's financial assistance policy.
BillCheck reads a photo of your bill on your phone, compares every line and writes the letter. Check my bill.
Related codes
- CPT 90715: Tdap vaccine
- CPT 90686: Flu vaccine
- CPT J1885: Ketorolac (Toradol) injection, per 15 mg
- CPT J0696: Ceftriaxone injection, per 250 mg
- CPT J1100: Dexamethasone injection, per 1 mg
Frequently asked questions
How much does CPT J2405 cost?
It depends on where it is done. In 2024, Medicare's average allowed amount for CPT J2405 in an office setting was $0.09, and providers billed Medicare $6.57 on average. Hospitals can bill more. If you have no insurance, ask for the self-pay price before you pay.
Why is the drug price on my bill so high?
Hospitals set their own price per unit. Compare the quantity with the dose you received and ask for the price per unit.
How do I question this charge?
Ask for an itemized bill, compare the line with the Medicare amount, then ask in writing for a fair price and for financial assistance. BillCheck writes the letter for you.