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See a sample rate comparisonHCPCS J2798 (Perseris) Fee Schedule
Medicare rates as of October 2026
HCPCS J2798 is classified under Drugs Administered Other than Oral Method, in the Drugs, Administered by Injection subgroup.
Injection, risperidone, (perseris), 0.5 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Complexity Level | Low |
| Medicare Fee Schedule | $12.19 per 0.5 mg (October 2026 ASP) · View Medicare rates for J2798 |
| Medicaid Fee Schedule | $12.11 median of the 8 states in the free preview · View Medicaid rates for J2798 |
| Medicare Payment Limit | $12.141  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 12496-0090-01 - PERSERIS 90 MG • 12496-0090-09 - PERSERIS 90 MG • 12496-0120-01 - PERSERIS 120 MG • 12496-0120-09 - PERSERIS 120 MG |
National average reimbursement for HCPCS J2798 by major payers:
$12.87
BCBS / Anthem
$12.47
UnitedHealthcare
$13.06
Aetna
$12.90
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS J2798.
HCPCS J2798
5 of 25 sample ratesHigher to lower in this preview
Fairview Health Services, Fairview Diagnostic Laboratory
$22.10Published rateTomah Memorial Hospital, Inc., Tomah Memorial Hospital
Tomah Memorial Hospital Inc
$14.60Published rateCarilion New River Valley Medical Center
Carilion Medical Center
$12.23Published rateHennepin Healthcare System, Inc, Hennepin County Medical Center
Hennepin Healthcare System Inc
$12.18Published rateGonzales Healthcare Systems
$4.65Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J2798 vs. Other Drugs, Administered by Injection Codes
The table lists codes related to J2798. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 12496-0090-01-NDC | Moderate | PERSERIS 90 MG |
| 12496-0090-09-NDC | Moderate | PERSERIS 90 MG |
| 12496-0120-01-NDC | Moderate | PERSERIS 120 MG |
| J2798-HCPCS | Low | Injection, risperidone, (perseris), 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 J2798. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2798 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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