What is the difference between an administration code and a J-code?

Administration codes (96360 through 96549) bill the act of giving an IV, infusion, or injection. J-codes bill the drug itself, such as saline (J7030) or ketorolac (J1885). In 2025, administration codes appeared in 106,545 disputes and J-codes in 73,730.

Which IV and injection code appears most often?

IV push of each added drug (96375) appeared in 46,907 disputes in 2025, then IV push of a first drug (96374) in 44,522 and hydration by the added hour (96361) in 42,021.

Do drug lines pay as much as administration lines?

No. Saline (J7030) decided at a median of $91.90 and ketorolac (J1885) at $38.75, against $576.00 for IV push of each added drug (96375) and $343.71 for an injection (96372).

Answers / Administration and drug codes

Infusion administration and drug codes in federal IDR

Under the No Surprises Act, infusion and injection claims bill two kinds of lines: administration codes for giving the IV or injection, and J-codes for the drug itself. In the 2025 files, IV push of each added drug (96375) had a median QPA of $93.90 and a median decided award of $576.00, and saline (J7030) a median QPA of $14.62 and award of $91.90. Provider wins on administration codes add up to $81.95 million in prevailing offers.

Administration codes: how the care is given

Five administration codes carry most of the volume. IV push of a first drug (96374) appears in 44,522 of the 2025 disputes, IV push of each added drug (96375) in 46,907, hydration by the added hour (96361) in 42,021, an injection under the skin or into muscle (96372) in 30,760, and the first therapeutic IV infusion (96365) in 23,697. Providers won 86.46, 87.48, 87.07, 85.95, and 88.32 percent of the disputes carrying each of them. Among lines that report a QPA and offers, medians decided at $454.35 against a $127.28 QPA for 96374, $576.00 against $93.90 for 96375, $353.58 against $94.87 for 96361, $343.71 against $86.91 for 96372, and $476.03 against $170.21 for 96365.

Drug lines: small dollars per line

J-codes appear in 73,730 disputes, 57.82 percent of the total. Saline (J7030) appears in 27,583 disputes and decided at a median of $91.90 against a $14.62 QPA across 13,354 lines. Ketorolac (J1885) appears in 25,449 disputes at $38.75 against $8.07, ondansetron (J2405) in 18,995 at $58.80 against $7.27, and dexamethasone (J1100) in 10,394 at $199.50 against $25.34. The dollars per line are small. Provider wins on IV push of added drugs (96375) add up to $18.6 million in prevailing offers for 2025, and wins on saline add up to $1.3 million.

The visit lines that travel with them

Most infusion and injection disputes are full emergency room visits: 93.76 percent carry an ED visit code. The level four and level five visit codes (99284 and 99285) appear in 57,927 and 47,888 disputes, blood counts (85025) in 69,953, metabolic panels (80053) in 54,920, urinalysis (81003) in 34,621, EKG tracings (93005) in 24,668, and abdominal and pelvic CT with contrast (74177) in 17,445. Providers won between 82.25 and 87.41 percent of the disputes carrying each of those codes. A dispute averages 3.37 lines, and 3,366 carry ten or more.

Pricing the offer

On both administration and drug lines, decided awards run well above the QPA, so an offer should be built from decided results for the same code, payer, and state. Medians are a guide, not a forecast: drug lines rest on small dollar amounts, and a large share of the volume is one Texas plan. Lido IDR derives each offer from the decided lines at idrexplorer.com, then files for a flat fee per arbitration.

Price each line from decided results

Lido IDR sets administration and drug line offers from decided lines for the same payer and state, then files for a flat fee per arbitration. Talk to an IDR specialist.