HCPCS J2806 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 |
| Complexity Level | Low |
National average reimbursement for HCPCS J2806 by major payers:

$42.41

$28.75

$N/A

$N/A
| 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 J2806 | ||||||
United | J2806 | $14.35 | 1588068431 - SHELLA FRENEL | 273459101 - (NY) GENESIS MEDICAL HEALTH PC | NY | General Acute Care Hospital (282N00000X) |
United | J2806 | $28.14 | 1326485749 - SOUTHERN REGIONAL MEDICAL CORPORATION, LEONARD J. CHABERT MEDICAL CENTER | 720824119 - (LA) SOUTHERN REGIONAL MEDICAL CORPORATION | LA | General Acute Care Hospital (282N00000X) |
United | J2806 | $25.34 | 1720030703 - THE MEMORIAL HOSPITAL OF WILLIAM F. AND GERTRUDE F. JONES, INC., JONES MEMORIAL HOSPITAL | 222807681 - (NY) MEMORIAL HOSPITAL OF WILLIAM F AND GERTRUDE F JONES INC | NY | General Acute Care Hospital (282N00000X) |
United | J2806 | $28.14 | 1568460772 - AVERA MCKENNAN, AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTER | 460224743 - AVERA MCKENNAN | SD | General Acute Care Hospital (282N00000X) |
United | J2806 | $29.51 | 1083781892 - ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC., TCU SNF | 350869066 - (IN) ST VINCENT HOSPITAL & HEALTH CARE | IN | General Acute Care Hospital (282N00000X) |
United | J2806 | $49.93 | 1447678768 - EUGENE OSWALD | 134010372 - (NY) MSKCC SURGERY GROUP | NJ | General Acute Care Hospital (282N00000X) |
United | J2806 | $28.14 | 1881643609 - BAY PINES VAMC | 593206683 - (FL) BAY PINES VAMC | FL | General Acute Care Hospital (282N00000X) |
United | J2806 | $29.84 | 1457619017 - DIMITRY HIKIN | 462916938 - (NY) MONTEFIORE MOUNT VERNON HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | J2806 | $28.14 | 1790868982 - MERCY HEALTH YOUNGSTOWN LLC, ST ELIZABETH BOARDMAN HOSPITAL | 851040784 | OH | General Acute Care Hospital (282N00000X) |
United | J2806 | $29.84 | 1245365196 - KALEIDA HEALTH, JOHN R. OISHEI CHILDREN'S HOSPITAL | 161533232 - KALEIDA HEALTH | NY | General Acute Care Hospital (282N00000X) |
United | J2806 | $28.14 | 1770543399 - RUSH MEDICAL FOUNDATION, OCHSNER RUSH MEDICAL CENTER | 640834532 - (MS) MEDICAL FOUNDATION INC NON PROFIT ORGANIZATION | MS | General Acute Care Hospital (282N00000X) |
United | J2806 | $29.00 | 1710067376 - MOUNT CARMEL HEALTH SYSTEM | 311439334 - MOUNT CARMEL HEALTH SYSTEM | OH | General Acute Care Hospital (282N00000X) |
United | J2806 | $28.14 | 1598119083 - JEFFERY TUN | 952082686 - RIDGECREST REGIONAL HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | J2806 | $28.14 | 1841565082 - ILANA JERUD | 232743545 | NY | General Acute Care Hospital (282N00000X) |
United | J2806 | $28.14 | 1003367491 - LEGACY EMANUEL HOSPITAL & HEALTH CENTER, UNITY CENTER FOR BEHAVIORAL HEALTH-PES | 930386823 - LEGACY EMANUEL HOSPITAL & HEALTH CENTER | OR | 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 J2806 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2806 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 J2806 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 |
|---|---|---|
| J2805-HCPCS | Low | Injection, sincalide, 5 micrograms |
| J2806-HCPCS | Low | Injection, sincalide (maia) not therapeutically equivalent to j2805, 5 micrograms |
| J2810-HCPCS | Low | Injection, theophylline, per 40 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J2806. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2806 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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