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HCPCS J0717Medical Service

Injection Certolizumab Pegol 1 Mg Code May Be Used for Standard Insurance When Drug Administered Under the Direct Supervision of a Physician Not for Use When Drug Is Self Administered

Injection, certolizumab pegol, 1 mg (code may be used for standard insurance when drug administered under the direct supervision of a physician, not for use when drug is self administered). Clinical pricing breakdown and utilization metrics across 848 practicing doctors nationwide.

$13.00
Peer Median Charge
Gross billed rate
$4.92
Standard Baseline
Customary allowable
2.6x
National Markup
Charge vs baseline
848
Active Physicians
Billing this code
Planning care or already received a bill for CPT J0717?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $13.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $4.92 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:
  • "Does Dr. [Name] participate in my specific insurance plan network?"
  • "What is the total self-pay or cash rate for code J0717 if paid upfront?"
  • "Are there separate facility, anesthesia, or pathology fees associated with this procedure?"