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See a sample rate comparisonHCPCS J1811 (Fiasp) Fee Schedule
Last Verified: September 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.
Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 99 - Other POS None |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1811 |
| Medicare Payment Limit | $8.255  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00169-3201-11 - FIASP 100 U/1 ML • 00169-3206-11 - FIASP PUMPCART (1X1.6ML CARTRIDGE) 100 U/1 ML • 00169-3206-15 - FIASP PUMPCART (5X1.6ML CARTRIDGE) 100 U/1 ML |
National average reimbursement for HCPCS J1811 by major payers:
$8.67
$7.96
$8.58
$8.03
Compare published rates across providers.
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HCPCS J1811
5 of 25 sample ratesHigher to lower in this preview
Community Hospital Of Anderson & Madison County, Inc
Community Hospital Of Anderson- Madison County Inc
$17.36Published rateState Of Mississippi-University Of Mississippi Medical Center, University Of Mississippi Center-Grenada
$9.63Published rateSavoy Medical Management Group, Inc., Savoy Medical Center Hospital Based Physicians
Savoy Medical Management Group Inc
$7.90Published rateHca Physician Services
$7.90Published rateGonzales Healthcare Systems
$2.96Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J1811 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1811 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 J1811 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 |
|---|---|---|
| 00169-3201-11-NDC | Moderate | FIASP 100 U/1 ML |
| 00169-3206-11-NDC | Moderate | FIASP PUMPCART (1X1.6ML CARTRIDGE) 100 U/1 ML |
| 00169-3206-15-NDC | Moderate | FIASP PUMPCART (5X1.6ML CARTRIDGE) 100 U/1 ML |
| J1811-HCPCS | Low | Insulin (fiasp) for administration through dme (i.e., insulin pump) per 50 units |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1811. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1811 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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