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HCPCS J1160 (Digoxin) Fee Schedule

Last Verified: December 2025

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Injection, digoxin, up to 0.5 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

None

11 - Office

24 - Ambulatory Surgical Center

Complexity LevelLow
Medicare Payment Limit
$9.053BuyandBill.com
WAC Price
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Related NDC Codes

00641-1410-31 - DIGOXIN (USP) 0.25 MG/ML

00781-3059-95 - DIGOXIN (USP,10X2ML) 0.25 MG/ML

38779-0215-09 - DIGOXIN (U.S.P.)

70515-0260-10 - LANOXIN 0.25 MG/1 ML

70515-0261-10 - LANOXIN 0.25 MG/1 ML


National average reimbursement for HCPCS J1160 by major payers:

bcbs

$10.80

uhc

$29.50

aetna

$15.72

cigna

$16.14

Preview provider-level rates for...
For billing codeHCPCS J1160
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J1160

United
J1160$8.811033183942 - MONUMENT HEALTH NETWORK, INC., MONUMENT HEALTH BELLE FOURCHE CLINIC460360899 - MONUMENT HEALTH NETWORK INCSDGeneral Acute Care Hospital (282N00000X)
United
J1160$15.721306184916 - MARYAMNAZ FALAMAKI760010407NYGeneral Acute Care Hospital (282N00000X)
United
J1160$27.511629078712 - MERCY HOSPITAL10211534 - MERCY HOSPITALMEGeneral Acute Care Hospital (282N00000X)
United
J1160$15.721083094825 - JANET BRUNO-GASTON810972059 - (TX) CENTER OF REPRODUCTIVE MEDICINE, LLPCAGeneral Acute Care Hospital (282N00000X)
United
J1160$28.461902089816 - SOUTH CENTRAL REG MED CTR202818177MSGeneral Acute Care Hospital (282N00000X)
United
J1160$15.721346369212 - NEWARK WAYNE COMMUNITY HOSPITAL, NEWARK WAYNE COMM - PROF150584188 - (NY) NEWARK WAYNE COMMUNITY HOSPITALNYGeneral Acute Care Hospital (282N00000X)
United
J1160$15.721710330485 - ERLANGER HEALTH SYSTEM626000101 - ERLANGER MEDICAL CENTERTNGeneral Acute Care Hospital (282N00000X)
United
J1160$9.691386074516 - SETON HEALTH SYSTEM, INC.141776186 - (NY) SETON HEALTH SYSTEMNYGeneral Acute Care Hospital (282N00000X)
United
J1160$15.721285717298 - NIAGARA FALLS MEMORIAL MEDICAL CENTER160743094 - (NY) NIAGARA FALLS MEMORIAL MEDICAL CENTERNYGeneral Acute Care Hospital (282N00000X)
United
J1160$15.721043471568 - ELDESIA GRANGER520486540 - SINAI HOSPITAL OF BALTIMORE INCMDGeneral Acute Care Hospital (282N00000X)
United
J1160$15.721164964078 - ADRIELLE EL-DYSON OTOO900603487 - (NY) PHYSICIAN AFFILIATE GROUP OF NEW YORK PCNYGeneral Acute Care Hospital (282N00000X)
United
J1160$11.141720217839 - MAKINI CHISOLM-STRAKER611895173 - (NY) ICAHN SCHOOL OF MEDICINE AT MOUNT SINAINYGeneral Acute Care Hospital (282N00000X)
United
J1160$1.781265431829 - SALEM HEALTH, SALEM HOSPITAL930579722 - SALEM HEALTHORGeneral Acute Care Hospital (282N00000X)
United
J1160$13.571508859661 - MERCY HOSPITAL JEFFERSON, JEFFERSON MEMORIAL HOSPITAL ASSOCIATION430687077 - (MO) MERCY HOSPITAL JEFFERSONMOGeneral Acute Care Hospital (282N00000X)
United
J1160$15.721194113217 - PARK NICOLLET METHODIST HOSPITAL, PARK NICOLLET METHODIST HOSPITAL OUTPATIENT SURGERY CENTER610461753 - METHODIST HEALTH INCMNGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS J1160 vs. Other Drugs, Administered by Injection Codes

The HCPCS J1160 code is part of the Drugs Administered Other than Oral Method services used for Drugs, Administered by Injection. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS J1160 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
00641-1410-31-NDCModerateDIGOXIN (USP) 0.25 MG/ML
00781-3059-95-NDCModerateDIGOXIN (USP,10X2ML) 0.25 MG/ML
38779-0215-09-NDCModerateDIGOXIN (U.S.P.)
J1160-HCPCSLowInjection, digoxin, up to 0.5 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1160. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J1160 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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