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See a sample rate comparisonHCPCS J3031 (Ajovy Syringe) 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, fremanezumab-vfrm, 1 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 | 11 - Office None |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J3031 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 51759-0202-10 - AJOVY (AUTOINJECTOR,PF) 225 MG/1.5 ML • 51759-0202-22 - AJOVY (AUTOINJECTOR,PF) 225 MG/1.5 ML • 51759-0204-10 - AJOVY (PF,LATEX-FREE) 225 MG/1.5 ML |
National average reimbursement for HCPCS J3031 by major payers:
$3.39
$3.43
$3.42
$3.23
Compare published rates across providers.
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HCPCS J3031
5 of 25 sample ratesHigher to lower in this preview
Allina Health System, Allina Health Faribault Medical Center
Allina Health System
$7.71Published rateBanner Health, Banner Casa Grande Medical Center
Banner Health
$3.64Published rateAzita Taghavy
Azita Taghavy, A Professional Corp
$3.35Published rateWomen And Infants Hospital
Women & Infants Hospital Of Rhode Island
$3.35Published rateSoutheast Hospital, Mercy Hospital Southeast
Southeast Hospital
$1.85Published rate
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See a sample payer proposalHCPCS J3031 vs. Other Drugs, Administered by Injection Codes
The HCPCS J3031 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 J3031 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 |
|---|---|---|
| 51759-0202-10-NDC | Moderate | AJOVY (AUTOINJECTOR,PF) 225 MG/1.5 ML |
| 51759-0202-22-NDC | Moderate | AJOVY (AUTOINJECTOR,PF) 225 MG/1.5 ML |
| 51759-0204-10-NDC | Moderate | AJOVY (PF,LATEX-FREE) 225 MG/1.5 ML |
| J3031-HCPCS | Low | Injection, fremanezumab-vfrm, 1 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 J3031. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J3031 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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