HCPCS J2798 (Perseris) 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 | • None • 11 - Office • 50 - Federally Qualified 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 | • 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

$12.47

$13.06

$12.90
| 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 J2798 | ||||||
United | J2798 | $12.92 | 1881019248 - SUHAIB ANDRABI | 900603487 - (NY) PHYSICIAN AFFILIATE GROUP OF NEW YORK PC | NY | General Acute Care Hospital (282N00000X) |
United | J2798 | $12.43 | 1033134663 - SINAI HOSPITAL OF BALTIMORE INC, SINAI SURGERY ASSOCIATES | 520486540 - SINAI HOSPITAL OF BALTIMORE INC | MD | General Acute Care Hospital (282N00000X) |
United | J2798 | $12.92 | 1013934025 - CITY WIDE HEALTH FACILITY, INC. | 20570365 - (NY) CITY WIDE HEALTH FACILITY INC | NY | General Acute Care Hospital (282N00000X) |
United | J2798 | $4.65 | 1699768705 - GONZALES HEALTHCARE SYSTEMS | 741625013 | TX | General Acute Care Hospital (282N00000X) |
United | J2798 | $21.32 | 1396858999 - AROOSTOOK MEDICAL CENTER, NORTHERN LIGHT A.R. GOULD HOSPITAL | 10372148 - EASTERN MAINE HEALTHCARE SYSTEMS | ME | General Acute Care Hospital (282N00000X) |
United | J2798 | $12.18 | 1043529282 - BAY AREA MEDICA CENTER | 391528430 - AURORA MEDICAL CENTER BAY AREA INC | WI | General Acute Care Hospital (282N00000X) |
United | J2798 | $12.18 | 1578568481 - SLIDELL MEMORIAL HOSPITAL, ST TAMMANY PARISH HOSPITAL SERVICE DISTRICT #2 | 726014895 - (LA) SLIDELL MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | J2798 | $12.18 | 1043549397 - CLEVELAND CLINIC FLORIDA | 650003177 - CLEVELAND CLINIC FLORIDA A NONPROFIT CORPORATION | FL | General Acute Care Hospital (282N00000X) |
United | J2798 | $12.18 | 1568411395 - CHILLICOTHE VAMC | 316014208 - (OH) CHILLICOTHE VAMC | OH | General Acute Care Hospital (282N00000X) |
United | J2798 | $12.18 | 1073504981 - MURRAY-CALLOWAY COUNTY PUBLIC HOSPITAL CORPORATION | 610620567 | KY | General Acute Care Hospital (282N00000X) |
United | J2798 | $15.10 | 1639101751 - MASSACHUSETTS EYE AND EAR INFIRMARY | 222658209 - MASS GENERAL BRIGHAM INCORPORATED | MA | General Acute Care Hospital (282N00000X) |
United | J2798 | $12.18 | 1104057694 - SPECIALISTS HOSPITAL SHREVEPORT, LLC | 208810573 - (LA) SPECIALISTS HOSPITAL SHREVEPORT, L.L.C. | LA | General Acute Care Hospital (282N00000X) |
United | J2798 | $12.18 | 1033107743 - CROUSE HEALTH HOSPITAL, INC. | 160960470 - CROUSE HEALTH HOSPITAL INC | NY | General Acute Care Hospital (282N00000X) |
United | J2798 | $14.60 | 1457690471 - ST. VINCENT'S MEDICAL CENTER-CLAY COUNTY, INC., ASCENSION ST. VINCENT'S CLAY COUNTY | 461523194 - (FL) ACENSION ST VINCENT SOUTH SIDE | FL | General Acute Care Hospital (282N00000X) |
United | J2798 | $12.18 | 1447284898 - MERCY HOSPITAL LEBANON, MERCY HOSPITAL LEBANON | 431767432 - MERCY HOSPITAL LEBANON | MO | 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 J2798 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2798 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 J2798 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 |
|---|---|---|
| 12496-0090-01-NDC | Moderate | PERSERIS 90 MG |
| J2797-HCPCS | Low | Injection, rolapitant, 0.5 mg |
| J2798-HCPCS | Low | Injection, risperidone, (perseris), 0.5 mg |
| J2800-HCPCS | Low | Injection, methocarbamol, up to 10 ml |
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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