J2798 HCPCS code: Injection, risperidone, (perseris), 0.5 mg
J2798 is the HCPCS Level II code for injection, risperidone, (perseris), 0.5 mg. In 2024 Medicare paid an average of $1.69 per service for J2798 across 3,384 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 240 per day on DME suppliers. Medicare volume fell 47% from 2022 to 2024 (6,368 to 3,384 services). In 2024, about 33 clinicians billed Medicare for J2798 for 37 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2019-10-01 |
| Last action effective | 2022-01-01 |
Who bills J2798 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 33 |
| Medicare beneficiaries | 37 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J2798, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 6,368 | 14 | $4.65 | $3.70 |
| 2023 | 6,273 | 21 | $0.48 | $0.38 |
| 2024 | 3,384 | 37 | $2.14 | $1.69 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 240 | Prescribing Information |
| outpatient hospital claims | 240 | Prescribing Information |
| practitioner claims | 240 | Prescribing Information |
What changed for J2798
- 2019-10-01: J2798 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J2798?
J2798 is the HCPCS Level II code for injection, risperidone, (perseris), 0.5 mg. Short descriptor: "Inj., perseris, 0.5 mg".
How much does Medicare pay for J2798?
In 2024, the average Medicare payment was $1.69 per service (average allowed $2.14).
Does Medicare cover J2798?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J2798 can be billed per day?
240 on DME suppliers; 240 on outpatient hospital claims; 240 on practitioner claims (NCCI medically unlikely edits).
Related J27 codes
- J2700 — Injection, oxacillin sodium, up to 250 mg
- J2704 — Injection, propofol, 10 mg
- J2710 — Injection, neostigmine methylsulfate, up to 0.5 mg
- J2720 — Injection, protamine sulfate, per 10 mg
- J2724 — Injection, protein c concentrate, intravenous, human, 10 iu
- J2725 — Injection, protirelin, per 250 mcg
- J2730 — Injection, pralidoxime chloride, up to 1 gm
- J2760 — Injection, phentolamine mesylate, up to 5 mg
- J2765 — Injection, metoclopramide hcl, up to 10 mg
- J2770 — Injection, quinupristin/dalfopristin, 500 mg (150/350)
- J2777 — Injection, faricimab-svoa, 0.1 mg
- J2778 — Injection, ranibizumab, 0.1 mg
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Next steps
- Run a reimbursement report for a device billed under J2798
- Watch J2798 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J2798
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.