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HCPCS J2680 (Fluphenazine Decanoate) Fee Schedule

Last Verified: January 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, 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$24.681427806025 - LEE HEALTH SYSTEM INC, LEE PHARMACY #1992646504FLGeneral Acute Care Hospital (282N00000X)
United
J2680$9.401942485321 - SUMMIT GUPTA270759755MDGeneral Acute Care Hospital (282N00000X)
United
J2680$10.211427009828 - RED BUD ILLINOIS HOSPITAL COMPANY, LLC, RED BUD REGIONAL HOSPITAL884142509ILGeneral Acute Care Hospital (282N00000X)
United
J2680$17.021982031563 - UPMC ALTOONA, UPMC HUNTINGDON FAMILY PHYSICIANS231352155 - UPMCPAGeneral 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$15.471225249865 - NYU MEDICAL CENTER135562308 - NEW YORK UNIVERSITYNYGeneral Acute Care Hospital (282N00000X)
United
J2680$10.211295995785 - UNION HOSPITAL CECIL COUNTY520607945 - UNION HOSPITAL OF CECIL COUNTYMDGeneral Acute Care Hospital (282N00000X)
United
J2680$35.611306131826 - UCSD EMERGENCY MEDICINE330702174CAGeneral Acute Care Hospital (282N00000X)
United
J2680$9.401699819003 - TAKOMA REGIONAL HOSPITAL INC, BALLAD HEALTH MEDICAL ASSOCIATES510603966 - TAKOMA REGIONAL HOSPITAL INCTNGeneral Acute Care Hospital (282N00000X)
United
J2680$10.211497784144 - MERCER COUNTY JOINT TOWNSHIP COMMUNITY HOSPITAL, MERCER HEALTH341101385OHGeneral Acute Care Hospital (282N00000X)
United
J2680$9.401730508250 - PRIME HEALTHCARE SERVICES, ST. MARY'S HOSPITAL463499370NJGeneral Acute Care Hospital (282N00000X)
United
J2680$10.211114023512 - DEACONESS WOMEN'S HOSPITAL OF SOUTHERN INDIANA, LLC, THE WOMEN'S HOSPITAL352062016 - (IN) DEACONESS WOMENS HOSPITAL OF SOUTHERN INDIANA, LLCINGeneral Acute Care Hospital (282N00000X)
United
J2680$9.401497723407 - COLORADO WEST HEALTHCARE SYSTEM, COMMUNITY HOSPITAL475312741COGeneral Acute Care Hospital (282N00000X)
United
J2680$42.501326320003 - GHALEB DARWAZEH330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSMMDGeneral Acute Care Hospital (282N00000X)
United
J2680$9.891295085470 - WAR MEMORIAL HOSPITAL INC, D.B.A WAR MULTI-SPECIALTY CLINIC800407200 - VALLEY HEALTH SYSTEMWVGeneral 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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