HCPCS J2680 (Fluphenazine Decanoate) Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Drugs Administered Other than Oral Method • Drugs, Administered by Injection |
| Common Place of Service | • 11 - Office • None • 53 - Community Mental Health Center |
| Complexity Level | Low |
| Medicare Payment Limit | |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00143-9529-01 - FLUPHENAZINE DECANOATE 25 MG/1 ML • 25021-0838-05 - FLUPHENAZINE DECANOATE (MDV,LATEX-FREE) 25 MG/1 ML • 42023-0129-01 - FLUPHENAZINE DECANOATE (LATEX-FREE) 25 MG/ML • 42023-0129-89 - PREMIERPRO RX FLUPHENAZINE DECANOATE (LATEX-FREE) 25 MG/1 ML • 51927-2234-00 - FLUPHENAZINE DECANOATE (U.S.P.) |
National average reimbursement for HCPCS J2680 by major payers:

$10.99

$11.18

$12.28

$11.27
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS J2680 | ||||||
United | J2680 | $9.40 | 1366573263 - KING'S DAUGHTERS MEDICAL CENTER | 610444716 - ASHLAND HOSPITAL CORPORATION | MS | General Acute Care Hospital (282N00000X) |
United | J2680 | $9.40 | 1194741181 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF PEDIATRICS, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | J2680 | $9.40 | 1083614382 - ROBERT PACKER HOSPITAL | 240795463 - (PA) ROBERT PACKER HOSPITAL | PA | General Acute Care Hospital (282N00000X) |
United | J2680 | $6.75 | 1407219181 - SARAH ALLEN | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | CA | General Acute Care Hospital (282N00000X) |
United | J2680 | $10.21 | 1356391247 - ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC., ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC. | 390816818 - ASCENSION NE WISCONSIN INC | WI | General Acute Care Hospital (282N00000X) |
United | J2680 | $10.81 | 1073975942 - JENNIFER DROUET | 61578286 - DOWNTOWN BRONX MEDICAL ASSOCIATES PC | NY | General Acute Care Hospital (282N00000X) |
United | J2680 | $10.88 | 1972664530 - BAPTIST HEALTH CARE, INC., GULF BREEZE HOSPITAL | 590657322 - BAPTIST HEALTH CARE INC | FL | General Acute Care Hospital (282N00000X) |
United | J2680 | $11.22 | 1568460772 - AVERA MCKENNAN, AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTER | 460224743 - AVERA MCKENNAN | SD | General Acute Care Hospital (282N00000X) |
United | J2680 | $11.26 | 1184721722 - MERCY HOSPITAL OKLAHOMA CITY, INC | 730579285 - MERCY HOSPITAL OKLAHOMA CITY INC | OK | General Acute Care Hospital (282N00000X) |
United | J2680 | $10.21 | 1427009828 - RED BUD ILLINOIS HOSPITAL COMPANY, LLC, RED BUD REGIONAL HOSPITAL | 884142509 | IL | General Acute Care Hospital (282N00000X) |
United | J2680 | $10.82 | 1376564088 - MCLAREN OAKLAND, PONTIAC OSTEOPATHIC HOSPITAL | 381428164 - MCLAREN OAKLAND | MI | General Acute Care Hospital (282N00000X) |
United | J2680 | $10.36 | 1780707257 - LSU HEALTH SCIENCES CENTER | 452297609 | LA | General Acute Care Hospital (282N00000X) |
United | J2680 | $9.97 | 1366947210 - JASON RAGGI | 61578286 - DOWNTOWN BRONX MEDICAL ASSOCIATES PC | NY | General Acute Care Hospital (282N00000X) |
United | J2680 | $8.93 | 1063426823 - MEMORIAL HEALTH SYSTEMS INC, FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER | 590973502 - MEMORIAL HEALTH SYSTEMS INC | FL | General Acute Care Hospital (282N00000X) |
United | J2680 | $8.47 | 1841816303 - RICHARD MENJIVAR | 208088453 - (NY) SAMARITAN MEDICAL SERVICES PC | NY | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS J2680 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2680 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 J2680 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 |
|---|---|---|
| 00143-9529-01-NDC | Moderate | FLUPHENAZINE DECANOATE 25 MG/1 ML |
| J2675-HCPCS | Low | Injection, progesterone, per 50 mg |
| J2680-HCPCS | Low | Injection, fluphenazine decanoate, up to 25 mg |
| J2690-HCPCS | Moderate | Injection, procainamide HCl, up to 1 gm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J2680. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2680 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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