In short

Risperdal Consta is billed under HCPCS J2794 — Injection, risperidone (risperdal consta), 0.5 mg. One billing unit is 0.5 mg. CMS's crosswalk lists 4 Risperdal Consta NDCs under this code.

J2794 code details

Reference

J2794
Injection, risperidone (risperdal consta), 0.5 mgBilling unit: 0.5 mg
Labelers
Janssen Pharmaceuticals, Inc.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$10.662
Per0.5 mg
Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Risperdal Consta units and claim line

Enter the dose given to get the J2794 units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

Risperdal Consta NDCs and billing units

From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.

Risperdal Consta NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
50458-0306-11J2794Janssen Pharmaceuticals, Inc.150
50458-0307-11J2794Janssen Pharmaceuticals, Inc.175
50458-0308-11J2794Janssen Pharmaceuticals, Inc.1100
50458-0309-11J2794Janssen Pharmaceuticals, Inc.125

Risperdal Consta: common questions

What is the J-code for Risperdal Consta?
Risperdal Consta is billed under HCPCS J2794 — Injection, risperidone (risperdal consta), 0.5 mg. One billing unit is 0.5 mg. CMS's crosswalk lists 4 Risperdal Consta NDCs under this code.
How many J2794 billing units are in a package of Risperdal Consta?
CMS lists 25 to 100 billing units per package, depending on the NDC, where one unit is 0.5 mg. Units to report are based on the dose given, not the package.
Is J2794 a CPT code?
No. J2794 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.

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