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See a sample rate comparisonHCPCS J1380 (Delestrogen) Fee Schedule
Last Verified: September 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, estradiol valerate, up to 10 mg
| 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 J1380 |
| Medicare Payment Limit | $7.248  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00143-9289-01 - ESTRADIOL VALERATE (MDV,LATEX-FREE) 10 MG/1 ML • 42023-0110-01 - DELESTROGEN (1X5ML,MULTIDOSE) 10 MG/ML • 70700-0273-22 - ESTRADIOL VALERATE (MDV,LATEX-FREE) 10 MG/1 ML |
National average reimbursement for HCPCS J1380 by major payers:
$8.93
$8.49
$9.72
$8.42
Compare published rates across providers.
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HCPCS J1380
5 of 25 sample ratesHigher to lower in this preview
Fairview Health Services, Fairview Diagnostic Laboratory
Fairview Clinics
$14.39Published rateLincoln Medical And Mental Health Center
New York City Health And Hospitals Corporation
$8.42Published rateMemorial Health Care System Inc., Memorial Hospital
Memorial Health Care System Inc
$7.94Published rateProvidence Health & Services Washington, Providence St Peter Hospital
$7.51Published rateWinchester Medical Center
Valley Health System
$0.07Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J1380 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1380 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 J1380 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 |
|---|---|---|
| 00143-9289-01-NDC | Moderate | ESTRADIOL VALERATE (MDV,LATEX-FREE) 10 MG/1 ML |
| 42023-0110-01-NDC | Moderate | DELESTROGEN (1X5ML,MULTIDOSE) 10 MG/ML |
| 70700-0273-22-NDC | Moderate | ESTRADIOL VALERATE (MDV,LATEX-FREE) 10 MG/1 ML |
| J1380-HCPCS | Low | Injection, estradiol valerate, up to 10 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1380. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1380 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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