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HCPCS J2806 Fee Schedule

Last Verified: December 2025

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, sincalide (maia) not therapeutically equivalent to j2805, 5 micrograms
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

None

11 - Office

Complexity LevelLow

National average reimbursement for HCPCS J2806 by major payers:

bcbs

$42.41

uhc

$28.75

aetna

$N/A

cigna

$N/A

Preview provider-level rates for...
For billing codeHCPCS J2806
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J2806

United
J2806$14.351588068431 - SHELLA FRENEL273459101 - (NY) GENESIS MEDICAL HEALTH PCNYGeneral Acute Care Hospital (282N00000X)
United
J2806$28.141326485749 - SOUTHERN REGIONAL MEDICAL CORPORATION, LEONARD J. CHABERT MEDICAL CENTER720824119 - (LA) SOUTHERN REGIONAL MEDICAL CORPORATIONLAGeneral Acute Care Hospital (282N00000X)
United
J2806$25.341720030703 - THE MEMORIAL HOSPITAL OF WILLIAM F. AND GERTRUDE F. JONES, INC., JONES MEMORIAL HOSPITAL222807681 - (NY) MEMORIAL HOSPITAL OF WILLIAM F AND GERTRUDE F JONES INCNYGeneral Acute Care Hospital (282N00000X)
United
J2806$28.141568460772 - AVERA MCKENNAN, AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTER460224743 - AVERA MCKENNANSDGeneral Acute Care Hospital (282N00000X)
United
J2806$29.511083781892 - ST. VINCENT HOSPITAL AND HEALTH CARE CENTER, INC., TCU SNF350869066 - (IN) ST VINCENT HOSPITAL & HEALTH CAREINGeneral Acute Care Hospital (282N00000X)
United
J2806$49.931447678768 - EUGENE OSWALD134010372 - (NY) MSKCC SURGERY GROUPNJGeneral Acute Care Hospital (282N00000X)
United
J2806$28.141881643609 - BAY PINES VAMC593206683 - (FL) BAY PINES VAMCFLGeneral Acute Care Hospital (282N00000X)
United
J2806$29.841457619017 - DIMITRY HIKIN462916938 - (NY) MONTEFIORE MOUNT VERNON HOSPITALNYGeneral Acute Care Hospital (282N00000X)
United
J2806$28.141790868982 - MERCY HEALTH YOUNGSTOWN LLC, ST ELIZABETH BOARDMAN HOSPITAL851040784OHGeneral Acute Care Hospital (282N00000X)
United
J2806$29.841245365196 - KALEIDA HEALTH, JOHN R. OISHEI CHILDREN'S HOSPITAL161533232 - KALEIDA HEALTHNYGeneral Acute Care Hospital (282N00000X)
United
J2806$28.141770543399 - RUSH MEDICAL FOUNDATION, OCHSNER RUSH MEDICAL CENTER640834532 - (MS) MEDICAL FOUNDATION INC NON PROFIT ORGANIZATIONMSGeneral Acute Care Hospital (282N00000X)
United
J2806$29.001710067376 - MOUNT CARMEL HEALTH SYSTEM311439334 - MOUNT CARMEL HEALTH SYSTEMOHGeneral Acute Care Hospital (282N00000X)
United
J2806$28.141598119083 - JEFFERY TUN952082686 - RIDGECREST REGIONAL HOSPITALNYGeneral Acute Care Hospital (282N00000X)
United
J2806$28.141841565082 - ILANA JERUD232743545NYGeneral Acute Care Hospital (282N00000X)
United
J2806$28.141003367491 - LEGACY EMANUEL HOSPITAL & HEALTH CENTER, UNITY CENTER FOR BEHAVIORAL HEALTH-PES930386823 - LEGACY EMANUEL HOSPITAL & HEALTH CENTERORGeneral 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 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.

CodeComplexityDescription
J2805-HCPCSLowInjection, sincalide, 5 micrograms
J2806-HCPCSLowInjection, sincalide (maia) not therapeutically equivalent to j2805, 5 micrograms
J2810-HCPCSLowInjection, 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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