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See a sample rate comparisonHCPCS J1954 (Lutrate Depot) 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, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office None |
| Complexity Level | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for J1954 |
| Medicare Payment Limit | $706.667  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 83831-0134-01 - LUTRATE DEPOT LYOPHILIZED 22.5 MG |
National average reimbursement for HCPCS J1954 by major payers:
$276.34
$287.61
$304.58
$278.90
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HCPCS J1954
5 of 25 sample ratesHigher to lower in this preview
Piedmont Newnan Hospital, Inc.
Piedmont Newnan Hospital Inc
$692.79Published rateWest Virginia University Hospitals, Inc.
West Virginia University Hospitals Inc
$332.45Published rateSt. Joseph'S Medical Center, Essentia Health-St. Joseph'S Medical Center
St Joseph S Medical Center
$258.80Published rateSt Josephs Hospital Health Center
$249.39Published rateRam Parekh
New York City Health And Hospitals Corporation
$184.46Published rate
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See a sample payer proposalHCPCS J1954 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1954 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 J1954 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 |
|---|---|---|
| 83831-0134-01-NDC | Moderate | LUTRATE DEPOT LYOPHILIZED 22.5 MG |
| J1953-HCPCS | Low | Injection, levetiracetam, 10 mg |
| J1954-HCPCS | Moderate | Injection, leuprolide acetate for depot suspension (lutrate depot), 7.5 mg |
| J1955-HCPCS | Low | Injection, levocarnitine, per 1 gm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1954. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1954 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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