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See a sample rate comparisonHCPCS J3030 (Sumatriptan Succinate) 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, sumatriptan succinate, 6 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 11 - Office 20 - Urgent Care Facility |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J3030 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00173-0449-02 - IMITREX (S.D.V.) 6 MG/0.5 ML • 00173-0739-00 - IMITREX STATDOSE 4 MG/0.5 ML • 00173-0739-02 - IMITREX STATDOSE (REFILL W/2 SYRINGES) 4 MG/0.5 ML • 00245-0809-38 - ZEMBRACE SYMTOUCH (AUTOINJECTOR) 3 MG/0.5 ML • 00245-0809-89 - ZEMBRACE SYMTOUCH (AUTOINJECTOR) 3 MG/0.5 ML |
National average reimbursement for HCPCS J3030 by major payers:
$41.96
$67.91
$65.02
$63.91
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HCPCS J3030
5 of 25 sample ratesHigher to lower in this preview
Pascack Valley Hospital
$230.24Published rateMillcreek Community Hospital
$75.30Published rateStephanie Blundell
Mountain Orthopaedics, LLC
$62.75Published rateChester River Hospital Center, University Of Maryland Shore Medical Center At Chestertown
Chester River Hospital Center
$62.75Published rateGonzales Healthcare Systems
$19.60Published rate
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See a sample payer proposalHCPCS J3030 vs. Other Drugs, Administered by Injection Codes
The HCPCS J3030 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 J3030 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 |
|---|---|---|
| 00173-0449-02-NDC | Moderate | IMITREX (S.D.V.) 6 MG/0.5 ML |
| 00173-0739-00-NDC | Moderate | IMITREX STATDOSE 4 MG/0.5 ML |
| 00173-0739-02-NDC | Moderate | IMITREX STATDOSE (REFILL W/2 SYRINGES) 4 MG/0.5 ML |
| J3030-HCPCS | Low | Injection, sumatriptan succinate, 6 mg (code may be used for Medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J3030. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J3030 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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