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See a sample rate comparisonHCPCS J1921 (Labetalol Hcl) 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, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 5 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Complexity Level | Low |
| Medicare Fee Schedule | $0.874 per 5 mg (October 2026 ASP) · View Medicare rates for J1921 |
| Medicaid Fee Schedule | $0.925 median of the 8 states in the free preview · View Medicaid rates for J1921 |
| Medicare Payment Limit | $1.382  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00143-9183-10 - LABETALOL HCL 10X4ML,SDV 5 MG/1 ML • 00641-6252-10 - LABETALOL HCL (10X2ML,SDS,PF) 5 MG/1 ML |
National average reimbursement for HCPCS J1921 by major payers:
$1.77
$1.74
$1.84
$1.76
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HCPCS J1921
5 of 25 sample ratesHigher to lower in this preview
Fairview Health Services, Fairview Diagnostic Laboratory
$2.95Published rateHeart Hospital Of South Dakota LLC, Avera Heart Hospital Of South Dakota LLC
Avera Health
$1.78Published rateIntermountain Front Range, Inc.
Scl Health - Front Range Inc
$1.62Published rateMiroslav Vytrisal
Ellis Hospital
$1.46Published rateCurators Of The University Of Missouri, Women'S And Children'S Hospital
$1.37Published rate
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See a sample payer proposalHCPCS J1921 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1921 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 J1921 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 |
|---|---|---|
| 00143-9183-10-NDC | Moderate | LABETALOL HCL 10X4ML,SDV 5 MG/1 ML |
| 00641-6252-10-NDC | Moderate | LABETALOL HCL (10X2ML,SDS,PF) 5 MG/1 ML |
| J1920-HCPCS | Low | Injection, labetalol hydrochloride, 5 mg |
| J1921-HCPCS | Low | Injection, labetalol hydrochloride (hikma), not therapeutically equivalent to j1920, 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 J1921. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1921 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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