HCPCS J2311 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 • 41 - Ambulance - Land • 50 - Federally Qualified Health Center • 11 - Office |
| Complexity Level | Low |
National average reimbursement for HCPCS J2311 by major payers:
$3.40
$2.15
$3.19
$1.94
| 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 J2311 | ||||||
United | J2311 | $1.50 | 1700975083 - GREEN CLINIC SURGICAL HOSPITAL, LLC | 721517132 - (LA) GREEN CLINIC SURGICAL HOSPITAL LLC | LA | General Acute Care Hospital (282N00000X) |
United | J2311 | $1.50 | 1205880945 - GALENCARE, INC., HCA FLORIDA NORTHSIDE HOSPITAL | 200603734 | FL | General Acute Care Hospital (282N00000X) |
United | J2311 | $2.17 | 1134550239 - MARKUS PLATE | 131623978 | NY | General Acute Care Hospital (282N00000X) |
United | J2311 | $1.35 | 1477579464 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF RADIOLOGY, FFP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | J2311 | $1.17 | 1669703245 - RUI DOMINGUES | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | J2311 | $12.72 | 1811927544 - MAURY REGIONAL HOSPITAL, WAYNE MEDICAL CENTER | 621605071 - (TN) MAURY REGIONAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | J2311 | $7.71 | 1801800594 - PORTERCARE ADVENTIST HEALTH SYSTEM, ADVENTHEALTH PORTER | 841294507 | CO | General Acute Care Hospital (282N00000X) |
United | J2311 | $27.29 | 1497847552 - UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER, UCSF MEDICAL CENTER | 943281660 | CA | General Acute Care Hospital (282N00000X) |
United | J2311 | $1.86 | 1639101751 - MASSACHUSETTS EYE AND EAR INFIRMARY | 222658209 - MASS GENERAL BRIGHAM INCORPORATED | MA | General Acute Care Hospital (282N00000X) |
United | J2311 | $1.59 | 1629294624 - MIROSLAV VYTRISAL | 30491689 - (NY) SCHENECTADY PULMONARY & CRITICAL CARE ASSOCIATES, P.C. | NY | General Acute Care Hospital (282N00000X) |
United | J2311 | $1.95 | 1518993880 - THEDACARE REGIONAL MEDICAL CENTER-NEENAH, INC., THEDA CLARK MEDICAL CENTER INC. | 390830664 - (WI) THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC | WI | General Acute Care Hospital (282N00000X) |
United | J2311 | $1.79 | 1790864023 - UNIVERSITY OF MISS MEDICAL CENTER, UNIVERSITY OF MS MEDICAL CENTER | 640507572 - HATTIESBURG CLINIC, P.A. | MS | General Acute Care Hospital (282N00000X) |
United | J2311 | $15.00 | 1225142193 - THE WESTERLY HOSPITAL, WESTERLY HOSPITAL EMERGENCY DEPARTMENT | 50259100 - (RI) WESTERLY HOSPITAL | RI | General Acute Care Hospital (282N00000X) |
United | J2311 | $1.59 | 1326589474 - JACOBI MEDICAL CENTER | 134169311 - (NY) NORTH BRONX FACULTY PRACTICE CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | J2311 | $1.50 | 1629316237 - RUCHI UPADHYAY | 900603487 - (NY) PHYSICIAN AFFILIATE GROUP OF NEW YORK PC | NY | 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 J2311 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2311 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 J2311 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 |
|---|---|---|
| J2310-HCPCS | Low | Injection, naloxone hydrochloride, per 1 mg |
| J2311-HCPCS | Low | Injection, naloxone hydrochloride (zimhi), 1 mg |
| J2315-HCPCS | Low | Injection, naltrexone, depot form, 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 J2311. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2311 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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