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See a sample rate comparisonHCPCS J2247 (Micafungin) 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.
Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 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 J2247 |
| Medicare Payment Limit | $0.371  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 42023-0229-10 - MICAFUNGIN (SDV,PF,LATEX-FREE) 50 MG • 42023-0230-10 - MICAFUNGIN (SDV,PF,LATEX-FREE) 100 MG |
National average reimbursement for HCPCS J2247 by major payers:
$0.49
$0.42
$0.51
$0.41
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HCPCS J2247
5 of 25 sample ratesHigher to lower in this preview
Cabell Huntington Hospital Inc
$1.79Published rateAscension Ne Wisconsin, Inc, Ascension Ne Wisconsin Surgery Center
$0.49Published rateRed Bud Illinois Hospital Company, LLC, Red Bud Regional Hospital
$0.34Published ratePhoenix Vamc
$0.31Published rateSsm Health Care St. Louis, Ssm Health St. Mary'S Hospital - St. Louis
Ssm Health Care St. Louis
$0.11Published rate
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See a sample payer proposalHCPCS J2247 vs. Other Drugs, Administered by Injection Codes
The HCPCS J2247 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 J2247 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 |
|---|---|---|
| 42023-0229-10-NDC | Moderate | MICAFUNGIN (SDV,PF,LATEX-FREE) 50 MG |
| 42023-0230-10-NDC | Moderate | MICAFUNGIN (SDV,PF,LATEX-FREE) 100 MG |
| J2212-HCPCS | Low | Injection, methylnaltrexone, 0.1 mg |
| J2247-HCPCS | Low | Injection, micafungin sodium (par pharm) not thereapeutically equivalent to j2248, 1 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J2247. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J2247 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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