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HCPCS J3010 (Fentanyl Citrate) 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, fentanyl Citrate, 0.1 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

None

11 - Office

24 - Ambulatory Surgical Center

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for J3010
Medicare Payment Limit
$1.098BuyandBill.com
WAC Price
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Related NDC Codes

• 00406-1130-52 - FENTANYL CITRATE

• 00409-9094-22 - FENTANYL CITRATE (FTV,25X2ML,LATEX-FREE) 0.05 MG/ML

• 00409-9094-25 - FENTANYL CITRATE (VIAL,FLIPTOP,LATEX-FREE) 0.05 MG/ML

• 00409-9094-28 - FENTANYL CITRATE (25X10ML,FTV) 0.05 MG/ML

• 00409-9094-31 - FENTANYL CITRATE (FTV,LATEX-FREE) 0.05 MG/ML


National average reimbursement for HCPCS J3010 by major payers:

bcbs

$0.87

uhc

$0.98

aetna

$1.09

cigna

$1.02

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J3010.

HCPCS J3010
5 of 25 sample ratesHigher to lower in this preview
  1. Sutter Bay Hospitals, Sutter Delta Medical Center

    Sutter Bay Hospitals

    CAGeneral Acute Care HospitalNPI 1467808659Tax ID 94-0562680

    $2.39Published rate
  2. Dimitry Hikin

    Open Door Family Medical Center Inc

    NYGeneral Acute Care HospitalNPI 1457619017Tax ID 13-2813103

    $0.94Published rate
  3. Dr. Carolyn Langford Urologic Solutions, LLC

    Dr. Carolyn Langford Urologic Solutions LLC

    FLUrology PhysicianNPI 1366916843Tax ID 83-1081292

    $0.85Published rate
  4. Brandon Okeefe Rafaeli

    U T Physicians

    TXGeneral Acute Care HospitalNPI 1427410240Tax ID 76-0459500

    $0.85Published rate
  5. Gonzales Healthcare Systems, Memorial Hospital

    TXGeneral Acute Care HospitalNPI 1508859612Tax ID 74-1625013

    $0.34Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS J3010 vs. Other Drugs, Administered by Injection Codes

The HCPCS J3010 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 J3010 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.

CodeComplexityDescription
00406-1130-52-NDCModerateFENTANYL CITRATE
00409-9094-22-NDCModerateFENTANYL CITRATE (FTV,25X2ML,LATEX-FREE) 0.05 MG/ML
00409-9094-25-NDCModerateFENTANYL CITRATE (VIAL,FLIPTOP,LATEX-FREE) 0.05 MG/ML
J3010-HCPCSLowInjection, fentanyl Citrate, 0.1 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J3010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J3010 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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