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See a sample rate comparisonHCPCS J1790 (Droperidol) 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, droperidol, up to 5 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 J1790 |
| Medicare Payment Limit | $7.632  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00143-9514-25 - DROPERIDOL SDV 2.5 MG/1 ML • 00143-9515-25 - DROPERIDOL SDV 2.5 MG/1 ML • 00517-9702-25 - DROPERIDOL (S.D.V.) 2.5 MG/ML • 51927-2182-00 - DROPERIDOL (USP) |
National average reimbursement for HCPCS J1790 by major payers:
$9.91
$9.81
$10.25
$7.64
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HCPCS J1790
5 of 25 sample ratesHigher to lower in this preview
North Shore Medical Center, Inc., North Shore Medical Center
$35.00Published rateAsante Three Rivers Medical Center, LLC
Asante Three Rivers Medical Center LLC
$11.61Published rateAmmar Nasser-Eddin
Physician Affiliate Group Of New York PC
$10.26Published rateMetropolitan Hospital, Metro Health Hospital
Metropolitan Hospital
$9.68Published rateKamil Lupicki
New York City Health And Hospitals Corporation
$7.03Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J1790 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1790 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 J1790 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 |
|---|---|---|
| 00143-9514-25-NDC | Moderate | DROPERIDOL SDV 2.5 MG/1 ML |
| 00143-9515-25-NDC | Moderate | DROPERIDOL SDV 2.5 MG/1 ML |
| 00517-9702-25-NDC | Moderate | DROPERIDOL (S.D.V.) 2.5 MG/ML |
| J1790-HCPCS | Low | Injection, droperidol, up to 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 J1790. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1790 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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