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See a sample rate comparisonHCPCS J1162 (Digifab) Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Injection, digoxin immune FAB(Ovine), per vial
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office |
| Complexity Level | High |
| Medicaid Fee Schedule | View Medicaid rates for J1162 |
| Medicare Payment Limit | $5168.229  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J1162 by major payers:
$4,573.71
$4,967.97
$5,141.58
$5,138.08
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HCPCS J1162
5 of 25 sample ratesHigher to lower in this preview
Cedars-Sinai Medical Center
Platinumcare La
$10,533.38Published rateTimur Mushekov
Montefiore Medical Center
$5,181.39Published rateWhite River Health System, Inc., White River Medical Center
White River Health System Inc
$5,069.97Published rateRiverside Medical Center, Crisis Residential Center
Riverside Medical Center
$4,888.10Published rateWajeeha Saeed
New York City Health And Hospitals Corporation
$3,832.27Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J1162 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1162 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 J1162 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.
| Code | Complexity | Description |
|---|---|---|
| J1160-HCPCS | Low | Injection, digoxin, up to 0.5 mg |
| J1162-HCPCS | High | Injection, digoxin immune FAB(Ovine), per vial |
| J1165-HCPCS | Low | Injection, phenytoin sodium, per 50 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1162. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1162 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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