No. J2794 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code.

What NDCs are billed under J2794?

CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 14 NDCs under J2794, for Risperdal Consta and Risperidone ER. The table on this page shows each one with its billing units per package.

What is the Medicare payment limit for J2794?

$10.662 per 0.5 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.

What is one billing unit of J2794?

One unit of J2794 is 0.5 mg, as stated in the code's descriptor. Units to report = dose given ÷ 0.5 mg.

J2794 J-Code: Risperdal Consta (risperidone)

In short

J2794 is the HCPCS Level II code for injection, risperidone (risperdal consta), 0.5 mg. CMS assigns NDCs for Risperdal Consta and Risperidone ER to it. One billing unit is 0.5 mg. The Medicare Part B payment limit is $10.662 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file

HCPCS codeJ2794

Billing unit0.5 mg

Descriptor: Injection, risperidone (risperdal consta), 0.5 mg
Short descriptor: Inj risperdal consta, 0.5 mg
Code set: HCPCS Level II, maintained by CMS
Effective: Oct 1, 2019

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

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

Units and claim line

Units = dose given ÷ 0.5 mg. For example, 50 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Dose given (mg)

HCPCS units (1 unit = 0.5 mg)

Modifier

NDC (11-digit)

NDC unit qualifier

NDC quantity

Enter the dose given to build the claim line.

NDCs billed under J2794

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 14 NDCs to J2794 for Risperdal Consta and Risperidone ER. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J2794 in the CMS ASP crosswalk
Drug	NDC (11-digit)	Labeler	Package	Billing units per package
Risperdal Consta	50458-0306-11	Janssen Pharmaceuticals, Inc.	1	50
Risperdal Consta	50458-0307-11	Janssen Pharmaceuticals, Inc.	1	75
Risperdal Consta	50458-0308-11	Janssen Pharmaceuticals, Inc.	1	100
Risperdal Consta	50458-0309-11	Janssen Pharmaceuticals, Inc.	1	25
Risperidone ER	00480-1232-08	Teva Pharmaceuticals USA, Inc.	1	50
Risperidone ER	00480-1342-08	Teva Pharmaceuticals USA, Inc.	1	75
Risperidone ER	00480-1453-08	Teva Pharmaceuticals USA, Inc.	1	100
Risperidone ER	00480-1554-08	Teva Pharmaceuticals USA, Inc.	1	25
Risperidone ER	70121-2626-05	Amneal Pharmaceuticals, LLC	1	50
Risperidone ER	70121-2627-05	Amneal Pharmaceuticals, LLC	1	75
Risperidone ER	70121-2628-05	Amneal Pharmaceuticals, LLC	1	100
Risperidone ER	70748-0270-13	Lupin Pharmaceuticals, Inc.	1	50
Risperidone ER	70748-0271-13	Lupin Pharmaceuticals, Inc.	1	75
Risperidone ER	70748-0272-13	Lupin Pharmaceuticals, Inc.	1	100

J2794: common questions

Is J2794 a CPT code?: No. J2794 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under J2794?: CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 14 NDCs under J2794, for Risperdal Consta and Risperidone ER. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J2794?: $10.662 per 0.5 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.
What is one billing unit of J2794?: One unit of J2794 is 0.5 mg, as stated in the code's descriptor. Units to report = dose given ÷ 0.5 mg. J-code billing units.

J2794 — Injection, risperidone (risperdal consta), 0.5 mg