HCPCS J1790 (Droperidol) Fee Schedule
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.
| 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 |
| Medicare Payment Limit | |
| 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
| 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 J1790 | ||||||
United | J1790 | $10.26 | 1679697544 - AMMAR NASSER-EDDIN | 900603487 - (NY) PHYSICIAN AFFILIATE GROUP OF NEW YORK PC | NY | General Acute Care Hospital (282N00000X) |
United | J1790 | $11.84 | 1326079534 - CHILDRESS COUNTY HOSPITAL DISTRICT, CHILDRESS REGIONAL MEDICAL CENTER | 751228349 | TX | General Acute Care Hospital (282N00000X) |
United | J1790 | $9.68 | 1730710898 - FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, FROEDTERT COMMUNITY HOSPITAL | 390987025 - (WI) COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC | WI | General Acute Care Hospital (282N00000X) |
United | J1790 | $10.26 | 1073975942 - JENNIFER DROUET | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | J1790 | $10.63 | 1528079753 - BON SECOURS ST. MARY'S HOSPITAL OF RICHMOND LLC, BON SECOURS ST MARY'S HOSPITAL OF RICHMOND PRO FEE SERVICES | 540793767 - (VA) BON SECOURS ST MARYS HOSPITAL OF RICHMOND LLC | VA | General Acute Care Hospital (282N00000X) |
United | J1790 | $14.90 | 1699714717 - GREENWOOD LEFLORE HOSPITAL | 646000400 - (MS) GREENWOOD LEFLORE HOSPITAL | MS | General Acute Care Hospital (282N00000X) |
United | J1790 | $8.94 | 1841667458 - CHRISTOPHER ORPIANO | 453220509 - (CA) REEDLEY COMMUNITY HOSPITAL | CA | General Acute Care Hospital (282N00000X) |
United | J1790 | $13.11 | 1356366314 - LEXINGTON COUNTY HEALTH SERVICES DISTRICT INC, LEXINGTON MEDICAL CENTER | 852276567 - LEXINGTON HEALTH INC | SC | General Acute Care Hospital (282N00000X) |
United | J1790 | $19.12 | 1164424305 - DOUGLAS COUNTY HOSPITAL, ALOMERE HEALTH | 411410148 - (MN) DOUGLAS COUNTY HOSPITAL | MN | General Acute Care Hospital (282N00000X) |
United | J1790 | $35.00 | 1720019995 - NORTH SHORE MEDICAL CENTER, INC., NORTH SHORE MEDICAL CENTER | 650638215 | FL | General Acute Care Hospital (282N00000X) |
United | J1790 | $10.63 | 1518916048 - NORTON, THE BETHANY CIRCLE OF KING'S DAUGHTERS' HEALTH OF MADISON, INDIANA, IN | 350895832 - (IN) NORTON - KINGS DAUGHTERS HEALTH INC | IN | General Acute Care Hospital (282N00000X) |
United | J1790 | $11.61 | 1720153968 - MILLCREEK COMMUNITY HOSPITAL, SHORT PROCEDURE UNIT | 251002937 - (PA) MILLCREEK COMMUNITY HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | J1790 | $11.61 | 1801891809 - ASANTE THREE RIVERS MEDICAL CENTER, LLC | 571181758 - (OR) ASANTE THREE RIVERS MEDICAL CENTER LLC | OR | General Acute Care Hospital (282N00000X) |
United | J1790 | $7.03 | 1326536087 - KAMIL LUPICKI | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | J1790 | $9.68 | 1043878325 - ARH TUG VALLEY HEALTH SERVICES, INC., HIGHLANDS ARH REGIONAL MEDICAL CENTER | 202470645 | KY | 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 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 |
| J1786-HCPCS | Low | Injection, imiglucerase, 10 units |
| J1790-HCPCS | Low | Injection, droperidol, up to 5 mg |
| J1800-HCPCS | Low | Injection, propranolol HCl, up to 1 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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