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See a sample rate comparisonHCPCS J2406 (Kimyrsa) 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, oritavancin (kimyrsa), 10 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office None |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J2406 |
| Medicare Payment Limit | $42.478  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J2406 by major payers:
$44.78
$43.58
$46.54
$45.04
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HCPCS J2406
5 of 25 sample ratesHigher to lower in this preview
Northside Hospital, Inc., Northside Hospital Cherokee
Northside Hospital Inc
$112.52Published rateCleveland County Healthcare System, Cleveland Regional Medical Center
$52.15Published rateGrady Memorial Hospital, Professional Medical Services
Grady Memorial Hospital
$43.31Published rateLsumc University Medical Center
$42.50Published rateDesoto Hospital Association, Desoto Regional Health System
Desoto Hospital Association
$40.08Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J2406 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2406 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 J2406 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 |
|---|---|---|
| J2405-HCPCS | Low | Injection, ondansetron hydrochloride, per 1 mg |
| J2406-HCPCS | Low | Injection, oritavancin (kimyrsa), 10 mg |
| J2407-HCPCS | Low | Injection, oritavancin (orbactiv), 10 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J2406. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2406 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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