HCPCS J2920 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 • 20 - Urgent Care Facility |
| Complexity Level | Low |
National average reimbursement for HCPCS J2920 by major payers:

$4.19

$4.19

$3.43

$4.27
| 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 J2920 | ||||||
United | J2920 | $4.30 | 1184886996 - JAKE KRIEG | 471345819 - (SC) PRISMA HEALTH MEDICAL GROUP-MIDLANDS | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $4.23 | 1710942305 - GREGORY FELDMAN | 560530233 - SOUTHEASTERN REGIONAL MEDICAL CENTER | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $3.43 | 1528324050 - CHRISTOPHER KEEN | 576000094 - (SC) BEAUFORT COUNTY MEMORIAL HOSPITAL | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $3.34 | 1639486160 - JARED INTAPHAN | 300150674 - (SC) SUMMERVILLE SLEEP CONSULTANTS LLC | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $5.34 | 1700833373 - ARMIN MEYER | 571004971 - PRISMA HEALTH-UNIVERSITY MEDICAL GROUP | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $4.13 | 1275583585 - CHANDAR ABBOY | 560845796 - CUMBERLAND COUNTY HOSPITAL SYSTEM INC | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $4.13 | 1174713879 - FADI SEIF | 853861695 - MUSC COMMUNITY PHYSICIANS | NC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $4.48 | 1518064302 - MARC JUDSON | 141338310 - ALBANY MEDICAL COLLEGE | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $4.44 | 1386621217 - MARCUM QUINN | 571004971 - PRISMA HEALTH-UNIVERSITY MEDICAL GROUP | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $4.13 | 1194834275 - JOHN CORTINA | 621490616 - BLUE RIDGE MEDICAL MANAGEMENT CORPORATION | FL | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $4.19 | 1407437114 - AKSHAR CORPORATIONS LLC | 861528212 - (SC) AKSHAR CORPORATIONS LLC | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $5.34 | 1730133547 - RAVI CHANDRAN | 571004971 - PRISMA HEALTH-UNIVERSITY MEDICAL GROUP | TX | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $6.44 | 1578879656 - ROPER SAINT FRANCIS PHYSICIANS NETWORK, ROPER ST. FRANCIS PHYSICIAN PARTNERS PULMONARY AND CRITICAL CARE | 262946628 - ROPER SAINT FRANCIS PHYSICIANS NETWORK | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $4.13 | 1912119371 - NANCY PATEL | 452956882 - (SC) PIEDMONT PULMONARY MEDICINE LLC | SC | Pulmonary Disease Physician (207RP1001X) |
United | J2920 | $4.13 | 1558411751 - LAURA HERPEL | 815342122 - (SC) BOGAN SLEEP CONSULTANTS, LLC | SC | Pulmonary Disease Physician (207RP1001X) |
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 J2920 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2920 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 J2920 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 |
|---|---|---|
| J2916-HCPCS | Low | Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg |
| J2920-HCPCS | Low | Injection, methylprednisolone sodium succinate, up to 40 mg |
| J2930-HCPCS | Low | Injection, methylprednisolone sodium succinate, up to 125 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J2920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2920 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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