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See a sample rate comparisonHCPCS J1980 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, hyoscyamine sulfate, up to 0.25 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 J1980 |
| Related NDC Codes | • 51927-1831-00 - HYOSCYAMINE SULFATE (U.S.P.) • 54288-0111-05 - HYOSCYAMINE SULFATE (5X1ML) 0.5 MG/1 ML |
National average reimbursement for HCPCS J1980 by major payers:
$51.14
$56.32
$52.27
$50.57
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HCPCS J1980
5 of 25 sample ratesHigher to lower in this preview
Vlad Tomuta
Montefiore Medical Center
$162.74Published rateLester E Cox Medical Centers, Cox Medical Centers
Lester E Cox Medical Center
$64.34Published rateTuality Healthcare, Thc Based Physicians
Tuality Healthcare
$55.61Published ratePhysicians Medical Center Of Santa Fe, LLC
Physicians Medical Center Of Santa Fe LLC
$55.61Published rateChca Conroe Lp, Conroe Regional Medical Center
Chca Conroe Lp
$15.38Published rate
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See a sample payer proposalHCPCS J1980 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1980 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 J1980 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 |
|---|---|---|
| 51927-1831-00-NDC | Moderate | HYOSCYAMINE SULFATE (U.S.P.) |
| 54288-0111-05-NDC | Moderate | HYOSCYAMINE SULFATE (5X1ML) 0.5 MG/1 ML |
| J1961-HCPCS | Low | Injection, lenacapavir (only for use as hiv treatment), 1 mg |
| J1980-HCPCS | Low | Injection, hyoscyamine sulfate, up to 0.25 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1980. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1980 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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