Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS J2794 (Risperdal Consta) Fee Schedule
Last Verified: October 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, risperidone (risperdal consta), 0.5 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office 50 - Federally Qualified Health Center |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J2794 |
| Medicare Payment Limit | $10.978  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 50458-0306-11 - RISPERDAL CONSTA 25 MG • 50458-0307-11 - RISPERDAL CONSTA 37.5 MG • 50458-0308-11 - RISPERDAL CONSTA 50 MG • 50458-0309-11 - RISPERDAL CONSTA 12.5 MG |
National average reimbursement for HCPCS J2794 by major payers:
$11.15
$11.61
$12.12
$11.96
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS J2794.
HCPCS J2794
5 of 25 sample ratesHigher to lower in this preview
Northside Hospital, Inc., Northside Hospital Gwinnett
Northside Hospital Inc
$33.40Published rateFauquier Medical Center LLC, Fauquier Hospital
$13.27Published rateNargis Jilani
Stony Brook Internists P C
$11.97Published rateRichard Menjivar
Samaritan Medical Services PC
$11.23Published rateVenkat Subramaniam
$10.93Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS J2794 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2794 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 J2794 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 |
|---|---|---|
| 50458-0306-11-NDC | Moderate | RISPERDAL CONSTA 25 MG |
| 50458-0307-11-NDC | Moderate | RISPERDAL CONSTA 37.5 MG |
| 50458-0308-11-NDC | Moderate | RISPERDAL CONSTA 50 MG |
| J2794-HCPCS | Low | Injection, risperidone (risperdal consta), 0.5 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J2794. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2794 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS J2794) and we'll show you how you compare in 15 minutes or less.