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See a sample rate comparisonHCPCS J0696 (Ceftriaxone) 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, ceftriaxone sodium, per 250 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office 20 - Urgent Care Facility |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J0696 |
| Medicare Payment Limit | $0.43  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00143-9678-01 - CEFTRIAXONE (PHARMACY BULK) 10 GM • 00264-3153-11 - CEFTRIAXONE/DEXTROSE 1 GM/50 ML • 00264-3155-11 - CEFTRIAXONE/DEXTROSE 2 GM/50 ML • 00338-5002-41 - CEFTRIAXONE 1 GM/50 ML • 00338-5003-41 - CEFTRIAXONE 2 GM/50 ML |
National average reimbursement for HCPCS J0696 by major payers:
$0.86
$1.03
$0.88
$0.58
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HCPCS J0696
5 of 25 sample ratesHigher to lower in this preview
Jeffery Gubbels
Memorial Hermann Medical Group
$64.00Published rateAmy Treece
Prisma Health-University Medical Group
$0.61Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$0.49Published rateMichael Denenberg
Southeast Pulmonary & Critical Care, LLC
$0.46Published rateKatherine Bligard
$0.43Published rate
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See a sample payer proposalHCPCS J0696 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0696 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 J0696 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 |
|---|---|---|
| 00143-9678-01-NDC | Moderate | CEFTRIAXONE (PHARMACY BULK) 10 GM |
| 00264-3153-11-NDC | Moderate | CEFTRIAXONE/DEXTROSE 1 GM/50 ML |
| 00264-3155-11-NDC | Moderate | CEFTRIAXONE/DEXTROSE 2 GM/50 ML |
| J0696-HCPCS | Low | Injection, ceftriaxone sodium, per 250 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0696. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0696 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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