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See a sample rate comparisonHealthcare 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 11 - Office 24 - Ambulatory Surgical Center |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J2372 |
| Medicare Payment Limit | |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 43598-0172-25 - BIORPHEN (PF,SULFITE-FREE) 100 MCG/1 ML |
National average reimbursement for HCPCS J2372 by major payers:

$0.18

$0.18

$0.21

$0.19
Choose a payer to see a sample of rates for HCPCS J2372.
Henry Ford Health System
Maimonides Medical Center
Greater Baltimore Medical Center
Magee Benevolent Association
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS 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.
| Code | Complexity | Description |
|---|---|---|
| 43598-0172-25-NDC | Moderate | BIORPHEN (PF,SULFITE-FREE) 100 MCG/1 ML |
| J2371-HCPCS | Low | Injection, phenylephrine hydrochloride, 20 micrograms |
| J2372-HCPCS | Low | Injection, phenylephrine hydrochloride (biorphen), 20 micrograms |
| J2401-HCPCS | Low | Injection, 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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