HCPCS J0716 (Anascorp) Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Drugs Administered Other than Oral Method • Drugs, Administered by Injection |
| Common Place of Service | • None • 99 - Other POS |
| Complexity Level | High |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J0716 by major payers:

$4,850.83

$5,516.29

$5,457.35

$5,041.33
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS J0716 | ||||||
United | J0716 | $5403.47 | 1912964081 - ST VINCENT INFIRMARY MEDICAL CENTER, ST VINCENT HEALTH SYSTEMS | 710236917 - (AR) ST VINCENT INFIRMARY MEDICAL CENTER | AR | General Acute Care Hospital (282N00000X) |
United | J0716 | $5980.54 | 1255401519 - THE MEDICAL CENTER INC, PIEDMONT COLUMBUS REGIONAL MIDTOWN | 581685139 - (GA) THE MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | J0716 | $9492.55 | 1285663856 - ROCKDALE MEDICAL CENTER INC., ROCKDALE HOSPITAL | 300999841 - (GA) PIEDMONT ROCKDALE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | J0716 | $9795.42 | 1841351749 - FAIRVIEW HEALTH SERVICES, FAIRVIEW DIAGNOSTIC LABORATORY | 410991680 - FAIRVIEW HEALTH SERVICES | MN | General Acute Care Hospital (282N00000X) |
United | J0716 | $5403.47 | 1417989773 - KALEIDA HEALTH, KALEIDA HEALTH - MILLARD SUBURBAN | 161533232 - KALEIDA HEALTH | NY | General Acute Care Hospital (282N00000X) |
United | J0716 | $5403.47 | 1952390122 - SSM AUDRAIN HEALTH CARE, INC, SSM HEALTH ST. MARY'S HOSPITAL-AUDRAIN | 431550298 - (MO) SSM AUDRAIN HEALTH CARE INC | MO | General Acute Care Hospital (282N00000X) |
United | J0716 | $5403.47 | 1619923919 - METROPOLITAN HOSPITAL, METRO HEALTH HOSPITAL | 380593405 - METROPOLITAN HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | J0716 | $5727.68 | 1528332970 - LINCOLN MEDICAL AND MENTAL HEALTH CENTER | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | J0716 | $12517.54 | 1124135132 - SUTTER DELTA MEDICAL CENTER, DELTA MEMORIAL HOSPITAL | 940562680 - (CA) SUTTER BAY HOSPITALS | CA | General Acute Care Hospital (282N00000X) |
United | J0716 | $5403.47 | 1639128069 - RENO VAMC | 880059762 | NV | General Acute Care Hospital (282N00000X) |
United | J0716 | $5403.47 | 1396709978 - BAPTIST MEMORIAL HOSPITAL-BOONEVILLE, INC. | 640663760 - (MS) BAPTIST MEMORIAL HOSPITAL BOONEVILLE INC | MS | General Acute Care Hospital (282N00000X) |
United | J0716 | $5403.47 | 1619947256 - MEMORIAL HOSPITAL, WAIVER | 356001853 - (IN) MEMORIAL HOSPITAL | IN | General Acute Care Hospital (282N00000X) |
United | J0716 | $14127.75 | 1467808659 - SUTTER BAY HOSPITALS, SUTTER DELTA MEDICAL CENTER | 940562680 - (CA) SUTTER BAY HOSPITALS | CA | General Acute Care Hospital (282N00000X) |
United | J0716 | $5403.47 | 1982621447 - ST. CHARLES HEALTH SYSTEM, INC., ST. CHARLES BEND | 930602940 - ST CHARLES HEALTH SYSTEM INC | OR | General Acute Care Hospital (282N00000X) |
United | J0716 | $8105.22 | 1497099063 - FARAH PIRACHA | 453023019 - (NY) NORTH SHORE-LIJ MEDICAL PC | NY | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS J0716 vs. Other Drugs, Administered by Injection Codes
The HCPCS J0716 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 J0716 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 |
|---|---|---|
| J0715-HCPCS | Low | Injection, ceftizoxime sodium, per 500 mg |
| J0716-HCPCS | High | Injection, centruroides immune f(ab)2, up to 120 milligrams |
| J0717-HCPCS | Low | Injection, certolizumab pegol, 1 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J0716. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J0716 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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