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See a sample rate comparisonHealthcare 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.
| 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 | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1652 |
| Medicare Payment Limit | |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00781-3443-12 - FONDAPARINUX SODIUM (PF,LATEX-FREE) 2.5 MG/0.5 ML • 00781-3443-95 - FONDAPARINUX SODIUM (PF,LATEX-FREE) 2.5 MG/0.5 ML • 00781-3454-12 - FONDAPARINUX SODIUM (PF,LATEX-FREE) 5 MG/0.4 ML • 00781-3454-95 - FONDAPARINUX SODIUM (PF,LATEX-FREE) 5 MG/0.4 ML • 00781-3465-12 - FONDAPARINUX SODIUM (PF,LATEX-FREE) 7.5 MG/0.6 ML |
National average reimbursement for HCPCS J1652 by major payers:

$1.18

$1.35

$1.56

$1.16
Choose a payer to see a sample of rates for HCPCS J1652.
Physician Affiliate Group Of New York PC
Good Shepherd Hospital Inc
Lompoc Valley Medical Center
New York City Health And Hospitals Corporation
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS J1652 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1652 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 J1652 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 |
|---|---|---|
| 00781-3443-12-NDC | Moderate | FONDAPARINUX SODIUM (PF,LATEX-FREE) 2.5 MG/0.5 ML |
| 00781-3443-95-NDC | Moderate | FONDAPARINUX SODIUM (PF,LATEX-FREE) 2.5 MG/0.5 ML |
| 00781-3454-12-NDC | Moderate | FONDAPARINUX SODIUM (PF,LATEX-FREE) 5 MG/0.4 ML |
| J1652-HCPCS | Low | Injection, fondaparinux sodium, 0.5 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1652. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1652 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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