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See a sample rate comparisonHCPCS J1260 Fee Schedule
Last Verified: October 2026
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, dolasetron mesylate, 10 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1260 |
National average reimbursement for HCPCS J1260 by major payers:
$8.91
$12.96
$6.25
$6.65
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HCPCS J1260
5 of 25 sample ratesHigher to lower in this preview
Lifemark Hospitals Of Florida, Inc., Palmetto General Hospital
$55.00Published rateUcsf Medical Center
$19.97Published rateLester E Cox Medical Centers, Cox Medical Centers
Lester E Cox Medical Center
$14.11Published rateJackson County Memorial Hospital Authority, Jackson Co Mem Hosp
$12.19Published rateOur Lady Of Lourdes Regional Medical Center,Inc
Our Lady Of Lourdes Regional Medical Center Inc
$4.46Published rate
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See a sample payer proposalHCPCS J1260 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1260 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 J1260 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 |
|---|---|---|
| J1250-HCPCS | Low | Injection, Dobutamine hydrochloride, per 250 mg |
| J1260-HCPCS | Low | Injection, dolasetron mesylate, 10 mg |
| J1265-HCPCS | Low | Injection, dopamine HCl, 40 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1260. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1260 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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