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See a sample rate comparisonHCPCS J1817 (Humalog) 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.
Insulin 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 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1817 |
| Medicare Payment Limit | $3.187  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00002-7510-01 - HUMALOG (VIAL) 100 U/ML • 00002-7510-99 - HUMALOG (VIAL) 100 U/1 ML • 00002-7533-01 - HUMALOG (MDV) 100 U/1 ML • 00002-7737-01 - INSULIN LISPRO 100 U/1 ML • 00002-8501-01 - HUMULIN R U-500 (VIAL, CONCENTRATED) 500 U/ML |
National average reimbursement for HCPCS J1817 by major payers:
$2.91
$2.62
$3.44
$2.84
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HCPCS J1817
5 of 25 sample ratesHigher to lower in this preview
Hialeah Hospital Inc., Hialeah Hospital
$60.00Published rateMarkus Plate
$3.27Published rateOtero County Hospital Association
$2.46Published rateUniversity Of Miss Medical Center, University Of Ms Medical Center
Mississippi Center For Advanced Medicine, PC
$2.38Published rateNorton Clark Hospital, LLC, Norton Clark Hospital
Clark Memorial Hospital
$1.78Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J1817 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1817 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 J1817 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 |
|---|---|---|
| 00002-7510-01-NDC | Moderate | HUMALOG (VIAL) 100 U/ML |
| 00002-7510-99-NDC | Moderate | HUMALOG (VIAL) 100 U/1 ML |
| 00002-7533-01-NDC | Moderate | HUMALOG (MDV) 100 U/1 ML |
| J1817-HCPCS | Low | Insulin 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 J1817. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1817 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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