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See a sample rate comparisonHCPCS J1749 (Aurlumyn) 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, iloprost, 0.1 mcg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1749 |
| Medicare Payment Limit | $5.713  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J1749 by major payers:
$5.77
$6.23
$6.04
$6.59
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HCPCS J1749
5 of 25 sample ratesHigher to lower in this preview
Scripps Health, Scripps Green Hospital
Scripps Health
$13.60Published rateWinston County Medical Foundation, Winston Medical Center
Winston County Medical Foundation
$6.26Published rateSt Joseph Medical Center, Osf Saint Joseph Medical Center
Osf Multi-Specialty Group
$5.73Published rateWildwood Sanitarium Incorporated, Wildwood Medical Clinic
Wildwood Sanitarium Incorporated
$5.67Published rateSt. Josephs Community Hospital Of West Bend Inc., Froedtert West Bend Hospital
Holy Family Memorial Inc
$5.67Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J1749 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1749 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 J1749 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 |
|---|---|---|
| J1749-HCPCS | Low | Injection, iloprost, 0.1 mcg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1749. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1749 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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