Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS J0275 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.
Alprostadil urethral suppository (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office None |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J0275 |
National average reimbursement for HCPCS J0275 by major payers:
$65.78
$71.93
$42.75
$27.35
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS J0275.
HCPCS J0275
5 of 25 sample ratesHigher to lower in this preview
Brigham And Women'S Hospital
Advocate Health And Hospitals Corporation
$95.51Published rateThe Unity Hospital Of Rochester, Park Ridge Hospital
The Unity Hospital Of Rochester
$75.73Published rateWest Carroll Health Systems LLC, Wchs Er Physicians
West Carroll Health Systems L.L.C.
$71.44Published rateBrfhh Shreveport LLC, University Health Shreveport
$71.44Published rateNorth Shore Medical Center, Inc., North Shore Medical Center
North Shore Medical Center Inc
$60.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS J0275 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0275 code is part of the Drugs Administered Other than Oral Method services used for Drugs, Administered by Injection. 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 J0275 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 |
|---|---|---|
| J0270-HCPCS | Low | Injection, alprostadil, 1.25 mcg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
| J0275-HCPCS | Low | Alprostadil urethral suppository (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
| J0278-HCPCS | Low | Injection, amikacin sulfate, 100 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0275. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0275 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS J0275) and we'll show you how you compare in 15 minutes or less.