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See a sample rate comparisonHCPCS J2326 (Spinraza) Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Injection, nusinersen, 0.1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Complexity Level | High |
| Medicaid Fee Schedule | $1,175.69 median of the 8 states in the free preview · View Medicaid rates for J2326 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J2326 by major payers:
$1,060.64
$1,245.10
$1,237.27
$1,201.92
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HCPCS J2326
5 of 25 sample ratesHigher to lower in this preview
Cleveland County Healthcare System, Kings Mountain Hospital
$2,986.93Published rateMcbride Clinic Orthopedic Hospital, LLC
Mcbride Orthopedic Hospital
$1,358.14Published rateCounty Of Tuolumne, Mother Lode Medical Center
$1,219.16Published rateSt Vincent Charity Medical Center, St Vincent Charity Medical Center
St Vincent Charity Medical Center
$1,219.16Published rateProgressive Acute Care Avoyelles, LLC, Avoyelles Hospital Physician Practice
$1,219.16Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J2326 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2326 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 J2326 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 |
|---|---|---|
| J2325-HCPCS | Low | Injection, nesiritide, 0.1 mg |
| J2326-HCPCS | High | Injection, nusinersen, 0.1 mg |
| J2327-HCPCS | Low | Injection, risankizumab-rzaa, intravenous, 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 J2326. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2326 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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