HCPCS Level II J2675: Progesterone Injection, 50 mg
Commercial payers pay $1 on average nationally for this procedure.
HCPCS Level II code J2675 describes an injection of progesterone, per 50 mg intended as a medication administration service, typically delivered as an intramuscular or subcutaneous therapeutic injection in outpatient settings such as clinics or physician offices; the code is used when billing for the drug product itself for clinical indications like menstrual disorders, amenorrhea, endometriosis, contraceptive surveillance, or ovarian insufficiency.
For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Antibody-Drug Conjugates, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only).
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National Reimbursement Benchmarks
National commercial reimbursement for J2675 centers around BUCA’s average commercial rate of $1.50, with notable variation across major carriers. Blue Cross Blue Shield’s central tendency sits higher than BUCA (median $1.50) while Aetna and UnitedHealth Group cluster below or near BUCA (medians $0.30 and $0.70, respectively). Cigna exhibits the highest mean at $3.60 driven by an extreme maximum of $59.50, which elevates its average relative to its median of $0.70.
Dispersion measured as the interquartile difference (P75 minus P25) highlights which payers are tight or wide: Aetna’s dispersion is $0.60, UnitedHealth Group is $0.10, Blue Cross Blue Shield is $1.00, Cigna is $0.20, and BUCA is $0.70. Blue Cross Blue Shield shows the widest IQR at $1.00, while UnitedHealth Group is the tightest at $0.10, indicating relatively consistent contracted rates for UnitedHealth Group compared with larger spread for Blue Cross Blue Shield.