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HCPCS J2372 (Biorphen) 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, phenylephrine hydrochloride (biorphen), 20 micrograms
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

None

11 - Office

24 - Ambulatory Surgical Center

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for J2372
Medicare Payment Limit
$0.166BuyandBill.com
WAC Price
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Related NDC Codes

43598-0172-25 - BIORPHEN (PF,SULFITE-FREE) 100 MCG/1 ML


National average reimbursement for HCPCS J2372 by major payers:

bcbs

$0.18

uhc

$0.18

aetna

$0.21

cigna

$0.19

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J2372.

HCPCS J2372
5 of 25 sample ratesHigher to lower in this preview
  1. Piedmont Walton Hospital Inc

    GAGeneral Acute Care HospitalNPI 1720589328Tax ID 82-4194264

    $0.34Published rate
  2. Henry Ford Health System, Henry Ford West Bloomfield Hospital

    Henry Ford Health System

    MIGeneral Acute Care HospitalNPI 1407867559Tax ID 38-1357020

    $0.18Published rate
  3. Velko Voynov

    Maimonides Medical Center

    NYGeneral Acute Care HospitalNPI 1578782108Tax ID 34-2010570

    $0.17Published rate
  4. Greater Baltimore Medical Center, Inc.

    Greater Baltimore Medical Center

    MDGeneral Acute Care HospitalNPI 1255372397Tax ID 52-6049658

    $0.17Published rate
  5. Magee Benevoent Association, Magee General Hospital Crna

    Magee Benevolent Association

    MSGeneral Acute Care HospitalNPI 1295856755Tax ID 64-0324402

    $0.17Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS J2372 vs. Other Drugs, Administered by Injection Codes

The HCPCS J2372 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 J2372 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.

CodeComplexityDescription
43598-0172-25-NDCModerateBIORPHEN (PF,SULFITE-FREE) 100 MCG/1 ML
J2371-HCPCSLowInjection, phenylephrine hydrochloride, 20 micrograms
J2372-HCPCSLowInjection, phenylephrine hydrochloride (biorphen), 20 micrograms
J2401-HCPCSLowInjection, chloroprocaine hydrochloride, per 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 J2372. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J2372 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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