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HCPCS J1675 (Histrelin Acetate) 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, histrelin acetate, 10 micrograms
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for J1675
WAC Price
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National average reimbursement for HCPCS J1675 by major payers:

bcbs

$180.00

uhc

$0.98

aetna

$1.08

cigna

$9.85

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J1675.

HCPCS J1675
5 of 25 sample ratesHigher to lower in this preview
  1. Fairview Health Services, Fairview Ridges Hospital

    Fairview Clinics

    MNGeneral Acute Care HospitalNPI 1245217520Tax ID 41-1761760

    $1.75Published rate
  2. Oneida Health Systems, Inc, Oneida Healthcare Center

    Oneida Healthcare Systems Inc

    NYGeneral Acute Care HospitalNPI 1962408203Tax ID 16-1492011

    $1.05Published rate
  3. University Of Kentucky

    Kentucky Medical Services Foundation Inc

    KYGeneral Acute Care HospitalNPI 1114181062Tax ID 61-0945743

    $1.00Published rate
  4. Louisville Vamc

    KYGeneral Acute Care HospitalNPI 1144279597Tax ID 61-0990338

    $0.97Published rate
  5. Physicians Medical Center, LLC

    LAGeneral Acute Care HospitalNPI 1477509859Tax ID 72-1275428

    $0.81Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS J1675 vs. Other Drugs, Administered by Injection Codes

The HCPCS J1675 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 J1675 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.

CodeComplexityDescription
J1670-HCPCSModerateInjection, tetanus immune globulin, human, up to 250 units
J1675-HCPCSLowInjection, histrelin acetate, 10 micrograms
J1700-HCPCSLowInjection, hydrocortisone acetate, up to 25 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1675. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J1675 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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