Home › Drug Codes › J Codes › J2680 · FLUPHENAZINE DECANOATE
Updated July 1st, 2026

FLUPHENAZINE DECANOATE J Code: J2680

Injection, fluphenazine decanoate, up to 25 mg

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Q4 2026 Medicare Payment Limit for J2680, effective October 1, 2026: $6.174 per HCPCS billing unit, up 6.8% from $5.781. From CMS's final file.

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Medicare Payment Limit ?
$5.781
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
Not published
CMS publishes none for Q3 2026
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
8
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Drug & Product Overview

HCPCS Descriptor Injection, fluphenazine decanoate, up to 25 mg
HCPCS Added Date January 1, 1982
Manufacturer Multiple Manufacturers
Route of Administration Intramuscular, Subcutaneous
Generic Status Multi-Source; Generic
Dosage Type Multi-Dose
Dosage Form Injection | Injection, Solution

About FLUPHENAZINE DECANOATE

Fluphenazine Decanoate is a medication aligned to the HCPCS J Code: J2680 for billing, pricing, and reimbursement purposes in the United States. It is a Psychiatric drug administered via the intramuscular or subcutaneous routes and manufactured by multiple companies.

According to CMS Drug Use Information: This medication is used to treat certain mental/mood disorders (such as schizophrenia). Fluphenazine decanoate is a long-acting form of fluphenazine. It may be used by people who have trouble remembering to take medication every day. Fluphenazine belongs to a class of drugs known as antipsychotics. It works by helping to restore the balance of certain natural substances in the brain. This medication is not recommended for use in children under 12 years of age.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. Showing 5 of 8 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
00143-9529-01 Fluphenazine Decanoate Hikma Pharmaceuticals USA Inc. 5 125 MG / 5 ML
25021-0838-05 Fluphenazine Decanoate Sagent Pharmaceuticals 5 125 MG / 5 ML
42023-0129-01 Fluphenazine Decanoate Par Health USA, LLC 5 125 MG / 5 ML
55150-0267-05 Fluphenazine Decanoate Eugia Us Llc 5 125 MG / 5 ML
63323-0272-05 Fluphenazine Decanoate Fresenius Kabi USA, LLC 5 125 MG / 5 ML
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FLUPHENAZINE DECANOATE
FLUPHENAZINE DECANOATE
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FLUPHENAZINE DECANOATE Pricing & Reimbursement

J2680 Private Payer Reimbursement
$6.59 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

FLUPHENAZINE DECANOATE CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular
Not on the CMS JW / JZ list

CMS does not include Fluphenazine Decanoate (J2680) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J2680. Wastage billing guide →

FLUPHENAZINE DECANOATE Medically Unlikely Edits (MUE)

The most billing units of J2680 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 25 mg.

Practitioner Office & Hospital Outpatient
4 units / day
= 100 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

FLUPHENAZINE DECANOATE Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Chronic schizophrenia
Drug Class
Phenothiazine [EPC]Phenothiazines [CS]

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Frequently Asked Questions

Is there an available Fluphenazine Decanoate billing and coding guide?
We have not yet identified a manufacturer source of Fluphenazine Decanoate billing and coding information.
Are there any available Fluphenazine Decanoate patient assistance programs?
Our team did not identify a source for Fluphenazine Decanoate patient assistance information. Please reach out to our team if you feel that this is a mistake.
Where can I find Fluphenazine Decanoate prescribing information?
Our team is still working to identify a prescribing information source for FLUPHENAZINE DECANOATE
Where can I find Fluphenazine Decanoate side effect information?
Our team has not yet identified a source of side effects information for FLUPHENAZINE DECANOATE. Please check back in a few weeks.
Does billing FLUPHENAZINE DECANOATE require JZ/JW wastage modifiers?
CMS does not include FLUPHENAZINE DECANOATE (J2680) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J2680. For more information, visit the link below.

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