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See a sample rate comparisonHCPCS J0561 (Bicillin L A) 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.
Injection, penicillin G benzathine, 100, 000 units
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office None 50 - Federally Qualified Health Center |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J0561 |
| Medicare Payment Limit | $30.011  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 54868-0753-00 - BICILLIN L-A (TUBEX) 600000 U/ML • 54868-0753-01 - BICILLIN L-A (TUBEX) 600000 U/ML |
National average reimbursement for HCPCS J0561 by major payers:
$25.18
$25.01
$26.72
$25.69
Compare published rates across providers.
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HCPCS J0561
5 of 25 sample ratesHigher to lower in this preview
Ascension Medical Group-Fox Valley Wisconsin, Inc, Ascension Medical Group
Ascension Medical Group-Fox Valley Wisconsin Inc
$34.11Published rateBanner Health Physicians West LLC
$26.81Published rateLaurel Pediatrics
Laurel Pediatrics Medical Group,Inc
$24.37Published rateAbout Care Gyn Associates, PLLC
About Care Obgyn Associates PC
$24.37Published rateHcma Consultants, Inc, Doctors Immedicare
Hcma Consultants Inc
$20.12Published rate
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See a sample payer proposalHCPCS J0561 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0561 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 J0561 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 |
|---|---|---|
| 54868-0753-00-NDC | Moderate | BICILLIN L-A (TUBEX) 600000 U/ML |
| 54868-0753-01-NDC | Moderate | BICILLIN L-A (TUBEX) 600000 U/ML |
| J0558-HCPCS | Low | Injection, penicillin G benzathine and penicillin G procaine, 100, 000 units |
| J0561-HCPCS | Low | Injection, penicillin G benzathine, 100, 000 units |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0561. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0561 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.
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