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HCPCS J2680 (Fluphenazine Decanoate) Fee Schedule

Last Verified: December 2025

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, fluphenazine decanoate, up to 25 mg
Key FactDetail
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 LevelLow
Medicare Payment Limit
$7.305BuyandBill.com
WAC Price
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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:

bcbs

$10.99

uhc

$11.18

aetna

$12.28

cigna

$11.27

Preview provider-level rates for...
For billing codeHCPCS J2680
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J2680

United
J2680$9.401366573263 - KING'S DAUGHTERS MEDICAL CENTER610444716 - ASHLAND HOSPITAL CORPORATIONMSGeneral Acute Care Hospital (282N00000X)
United
J2680$9.401194741181 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF PEDIATRICS, FPP113465690NYGeneral Acute Care Hospital (282N00000X)
United
J2680$9.401083614382 - ROBERT PACKER HOSPITAL240795463 - (PA) ROBERT PACKER HOSPITALPAGeneral Acute Care Hospital (282N00000X)
United
J2680$6.751407219181 - SARAH ALLEN132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATIONCAGeneral Acute Care Hospital (282N00000X)
United
J2680$10.211356391247 - ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC., ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS, INC.390816818 - ASCENSION NE WISCONSIN INCWIGeneral Acute Care Hospital (282N00000X)
United
J2680$10.811073975942 - JENNIFER DROUET61578286 - DOWNTOWN BRONX MEDICAL ASSOCIATES PCNYGeneral Acute Care Hospital (282N00000X)
United
J2680$10.881972664530 - BAPTIST HEALTH CARE, INC., GULF BREEZE HOSPITAL590657322 - BAPTIST HEALTH CARE INCFLGeneral Acute Care Hospital (282N00000X)
United
J2680$11.221568460772 - AVERA MCKENNAN, AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTER460224743 - AVERA MCKENNANSDGeneral Acute Care Hospital (282N00000X)
United
J2680$11.261184721722 - MERCY HOSPITAL OKLAHOMA CITY, INC730579285 - MERCY HOSPITAL OKLAHOMA CITY INCOKGeneral Acute Care Hospital (282N00000X)
United
J2680$10.211427009828 - RED BUD ILLINOIS HOSPITAL COMPANY, LLC, RED BUD REGIONAL HOSPITAL884142509ILGeneral Acute Care Hospital (282N00000X)
United
J2680$10.821376564088 - MCLAREN OAKLAND, PONTIAC OSTEOPATHIC HOSPITAL381428164 - MCLAREN OAKLANDMIGeneral Acute Care Hospital (282N00000X)
United
J2680$10.361780707257 - LSU HEALTH SCIENCES CENTER452297609LAGeneral Acute Care Hospital (282N00000X)
United
J2680$9.971366947210 - JASON RAGGI61578286 - DOWNTOWN BRONX MEDICAL ASSOCIATES PCNYGeneral Acute Care Hospital (282N00000X)
United
J2680$8.931063426823 - MEMORIAL HEALTH SYSTEMS INC, FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER590973502 - MEMORIAL HEALTH SYSTEMS INCFLGeneral Acute Care Hospital (282N00000X)
United
J2680$8.471841816303 - RICHARD MENJIVAR208088453 - (NY) SAMARITAN MEDICAL SERVICES PCNYGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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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.

CodeComplexityDescription
00143-9529-01-NDCModerateFLUPHENAZINE DECANOATE 25 MG/1 ML
J2675-HCPCSLowInjection, progesterone, per 50 mg
J2680-HCPCSLowInjection, fluphenazine decanoate, up to 25 mg
J2690-HCPCSModerateInjection, 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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