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See a sample rate comparisonHCPCS J2545 (Nebupent) 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.
Pentamidine isethionate, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, per 300 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J2545 |
| Medicare Payment Limit | $69.728  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 13925-0522-01 - PENTAMIDINE ISETHIONATE (PF) 300 MG • 23155-0748-41 - PENTAMIDINE ISETHIONATE (PF,LATEX-FREE) 300 MG • 39822-3030-02 - PENTAMIDINE ISETHIONATE (PF,LATEX-FREE) 300 MG • 63323-0877-15 - NEBUPENT (S.D.V.,PF) 300 MG |
National average reimbursement for HCPCS J2545 by major payers:
$84.22
$90.33
$96.95
$91.22
Compare published rates across providers.
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HCPCS J2545
5 of 25 sample ratesHigher to lower in this preview
University Hospital At Stony Brook, Stony Brook University Hospital
$170.22Published rateVelko Voynov
Maimonides Medical Center
$94.15Published rateTrinitas Regional Medical Center, Trinitas Hospital - Mobile Response - Cmr
Rwj Barnabas Health Inc
$85.52Published rateNassau Health Care Corporation, Numc Department Of Ob/Gyn, Fpp
$84.15Published rateNorth Shore Medical Center, Inc., North Shore Medical Center
$40.00Published rate
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See a sample payer proposalHCPCS J2545 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2545 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 J2545 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 |
|---|---|---|
| 13925-0522-01-NDC | Moderate | PENTAMIDINE ISETHIONATE (PF) 300 MG |
| 23155-0748-41-NDC | Moderate | PENTAMIDINE ISETHIONATE (PF,LATEX-FREE) 300 MG |
| 39822-3030-02-NDC | Moderate | PENTAMIDINE ISETHIONATE (PF,LATEX-FREE) 300 MG |
| J2545-HCPCS | Low | Pentamidine isethionate, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, per 300 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J2545. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2545 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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