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HCPCS J3246 (Aggrastat) 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, tirofiban HCl, 0.25mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Drugs, Administered by Injection

Common Place of Service

None

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for J3246
Medicare Payment Limit
$3.478BuyandBill.com
WAC Price
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Related NDC Codes

• 25208-0001-04 - AGGRASTAT (PF) 0.25 MG/1 ML

• 25208-0002-01 - AGGRASTAT (1X100ML) 0.05 MG/ML

• 25208-0002-02 - AGGRASTAT (1X250ML) 0.05 MG/ML


National average reimbursement for HCPCS J3246 by major payers:

bcbs

$3.85

uhc

$4.00

aetna

$4.45

cigna

$4.19

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J3246.

HCPCS J3246
5 of 25 sample ratesHigher to lower in this preview
  1. Scripps Clinic Medical Group

    Scripps Health

    CAGeneral Acute Care HospitalNPI 1356696496Tax ID 95-1684089

    $8.86Published rate
  2. Hh Health System, Marshall Medical Center

    ALGeneral Acute Care HospitalNPI 1407313760Tax ID 83-1651180

    $4.09Published rate
  3. Memorial Hospital, Albany, N.Y., Capital District Internal Medicine

    Samaritan Hospital

    NYGeneral Acute Care HospitalNPI 1487901351Tax ID 14-1338544

    $3.83Published rate
  4. Boulder Community Health, The Community Hospital Association

    Boulder Community Health

    COGeneral Acute Care HospitalNPI 1821074196Tax ID 84-0175870

    $3.82Published rate
  5. St. Charles Hospital

    St Charles Hospital Corp

    NYGeneral Acute Care HospitalNPI 1164481529Tax ID 11-1871039

    $3.25Published rate

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

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HCPCS J3246 vs. Other Drugs, Administered by Injection Codes

The HCPCS J3246 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 J3246 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
25208-0001-04-NDCModerateAGGRASTAT (PF) 0.25 MG/1 ML
25208-0002-01-NDCModerateAGGRASTAT (1X100ML) 0.05 MG/ML
25208-0002-02-NDCModerateAGGRASTAT (1X250ML) 0.05 MG/ML
J3246-HCPCSLowInjection, tirofiban HCl, 0.25mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J3246. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J3246 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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