J0696
J0696 – Injection, ceftriaxone sodium, per 250 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 99 NDCs crosswalked per 250 MG $0.404/unit ASP+6%
📋 J0696 summary
J0696 is a HCPCS Level II J-code used to bill ceftriaxone sodium, per 250 mg, billed per 250 MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Brand names associated with J0696: Ceftriaxone, Ceftriaxone And Dextrose, Ceftriaxone Sodium
Code J0696
Billing unit 250 MG Payment limit $0.404/unit NDC-Crosswalk 99
Quarter Q3 2026
RxCUI Atlas Trace the drug concept →
⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.
🗂️ Key billing facts
HCPCS codeJ0696
DescriptorInjection, ceftriaxone sodium, per 250 mg
Billing unit250 MG
Payment limit / unit$0.404
Est. ASP / unit$0.381 est.
Mapped NDCs99
Data periodQ3 2026
Last updated2026-08-20
💊 About Ceftriaxone Injection DRUG GUIDE
Ceftriaxone Injection is used to treat bacterial infections in many parts of the body, including the lungs (lower respiratory tract infections), urinary tract, skin, bones and joints, abdomen, and bloodstream (septicemia).
It also treats bacterial meningitis (infection of the lining around the brain and spinal cord), pelvic inflammatory disease, acute bacterial ear infections (otitis media), and gonorrhea.In addition, a single dose of ceftriaxone may be given before certain surgeries — such as hysterectomy, gallbladder surgery, or coronary artery bypass surgery — to help prevent postoperative infection.
It works only against bacterial infections; it will not treat viral illnesses like the flu or a cold.
Clinical overview from our editorial drug guide for Ceftriaxone Injection. For billing reference, see the sections above.
🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026
📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$0.404
Est. ASP / unit
$0.381 est.
Est. after 2% sequester
$0.396
HCPCS dosage
250 MG
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionInjection, ceftriaxone sodium, per 250 mg
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment group—
Action codeN — No maintenance this year
Effective date1997-01-01
Date added1990-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J0696 = 250 mg. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.
🔁 NDCs that bill under J0696 LEAST EXPENSIVE FIRST
99 NDCs map to J0696. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.404/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00409-7337-01 | Ceftriaxone Sodium 250 mg/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7337... | 250 mg/1 | 10 | $4.04 | $0.862 | ● Active | CMS + PDAC |
| 00409-7337-20 | Ceftriaxone Sodium 250 mg/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7337... | 250 mg/1 | 10 | $4.04 | $0.862 | ● Active | CMS + PDAC |
| 00781-3206-95 | Ceftriaxone Sodium 250 mg/1 INJECTION, POWDER, FOR SOLUTION | Sandoz | 10 VIAL, SINGLE-USE in 1 CARTON (0781-3206... | 250 mg/1 | 10 | $4.04 | $0.862 | ● Active | CMS + PDAC |
| 60505-6151-01 | Ceftriaxone Sodium 250 mg/1 INJECTION, POWDER, FOR SOLUTION | Apotex | 10 VIAL, SINGLE-USE in 1 CARTON (60505-615... | 250 mg/1 | 10 | $4.04 | $0.862 | ● Active | CMS + PDAC |
| 00409-7332-01 | Ceftriaxone Sodium 1 g/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7332... | 1 g/1 | 40 | $16.16 | $1.195 | ● Active | CMS + PDAC |
| 00409-7332-20 | Ceftriaxone Sodium 1 g/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7332... | 1 g/1 | 40 | $16.16 | $1.195 | ● Active | CMS + PDAC |
| 00781-3208-95 | Ceftriaxone Sodium 1 g/1 INJECTION, POWDER, FOR SOLUTION | Sandoz | 10 VIAL, SINGLE-USE in 1 CARTON (0781-3208... | 1 g/1 | 40 | $16.16 | $1.195 | ● Active | CMS + PDAC |
| 60505-6148-04 | Ceftriaxone Sodium 1 g/1 INJECTION, POWDER, FOR SOLUTION | Apotex | 10 VIAL, SINGLE-USE in 1 CARTON (60505-614... | 1 g/1 | 40 | $16.16 | $1.195 | ● Active | CMS + PDAC |
| 00781-3206-85 | Ceftriaxone Sodium 250 mg/1 INJECTION, POWDER, FOR SOLUTION | Sandoz | 1 VIAL, SINGLE-USE in 1 CARTON (0781-3206-... | 250 mg/1 | 1 | $0.40 | $1.253 | ● Active | CMS ASP |
| 60505-6151-04 | Ceftriaxone Sodium 250 mg/1 INJECTION, POWDER, FOR SOLUTION | Apotex | 1 VIAL, SINGLE-USE in 1 CARTON (60505-6151... | 250 mg/1 | 1 | $0.40 | $1.253 | ● Active | CMS + PDAC |
| 00409-7338-01 | Ceftriaxone Sodium 500 mg/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7338... | 500 mg/1 | 20 | $8.08 | $1.298 | ● Active | CMS + PDAC |
| 00409-7338-20 | Ceftriaxone Sodium 500 mg/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7338... | 500 mg/1 | 20 | $8.08 | $1.298 | ● Active | CMS + PDAC |
| 00781-3207-95 | Ceftriaxone Sodium 500 mg/1 INJECTION, POWDER, FOR SOLUTION | Sandoz | 10 VIAL, SINGLE-USE in 1 CARTON (0781-3207... | 500 mg/1 | 20 | $8.08 | $1.298 | ● Active | CMS + PDAC |
| 60505-6152-01 | Ceftriaxone Sodium 500 mg/1 INJECTION, POWDER, FOR SOLUTION | Apotex | 10 VIAL, SINGLE-USE in 1 CARTON (60505-615... | 500 mg/1 | 20 | $8.08 | $1.298 | ● Active | CMS + PDAC |
| 00143-9857-25 | Ceftriaxone 1 g/1 INJECTION, POWDER, FOR SOLUTION | Hikma | 25 VIAL in 1 BOX (0143-9857-25) / 1 INJEC... | 1 g/1 | 100 | $40.40 | $1.443 | ● Active | CMS ASP |
| 25021-0106-10 | Ceftriaxone 1 g/1 INJECTION, POWDER, FOR SOLUTION | Sagent | 25 VIAL in 1 CARTON (25021-106-10) / 1 IN... | 1 g/1 | 100 | $40.40 | $1.443 | ● Active | CMS ASP |
| 44567-0701-25 | Ceftriaxone 1 g/1 INJECTION, POWDER, FOR SOLUTION | WG | 25 VIAL in 1 CARTON (44567-701-25) / 1 IN... | 1 g/1 | 100 | $40.40 | $1.443 | ● Active | CMS + PDAC |
| 44567-0701-95 | Ceftriaxone 1 g/1 INJECTION, POWDER, FOR SOLUTION | WG | 25 VIAL in 1 CARTON (44567-701-95) / 1 IN... | 1 g/1 | 100 | $40.40 | $1.443 | ● Active | CMS + PDAC |
| 63323-0346-10 | Ceftriaxone 1 g/1 INJECTION, POWDER, FOR SOLUTION | Fresenius | 25 VIAL in 1 CARTON (63323-346-10) / 1 IN... | 1 g/1 | 100 | $40.40 | $1.443 | ● Active | CMS + PDAC |
| 72572-0061-25 | Ceftriaxone 1 g/1 INJECTION, POWDER, FOR SOLUTION | Civica, | 25 VIAL in 1 BOX (72572-061-25) / 1 INJEC... | 1 g/1 | 100 | $40.40 | $1.443 | ● Active | CMS + PDAC |
| 00781-3207-85 | Ceftriaxone Sodium 500 mg/1 INJECTION, POWDER, FOR SOLUTION | Sandoz | 1 VIAL, SINGLE-USE in 1 CARTON (0781-3207-... | 500 mg/1 | 2 | $0.81 | $1.808 | ● Active | CMS ASP |
| 60505-6152-04 | Ceftriaxone Sodium 500 mg/1 INJECTION, POWDER, FOR SOLUTION | Apotex | 1 VIAL, SINGLE-USE in 1 CARTON (60505-6152... | 500 mg/1 | 2 | $0.81 | $1.808 | ● Active | CMS + PDAC |
| 00409-7335-03 | Ceftriaxone Sodium 2 g/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7335... | 2 g/1 | 80 | $32.32 | $2.700 | ● Active | CMS ASP |
| 00409-7335-20 | Ceftriaxone Sodium 2 g/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7335... | 2 g/1 | 80 | $32.32 | $2.700 | ● Active | CMS + PDAC |
| 00781-3209-95 | Ceftriaxone Sodium 2 g/1 INJECTION, POWDER, FOR SOLUTION | Sandoz | 10 VIAL, SINGLE-USE in 1 CARTON (0781-3209... | 2 g/1 | 80 | $32.32 | $2.700 | ● Active | CMS + PDAC |
| 60505-6149-04 | Ceftriaxone Sodium 2 g/1 INJECTION, POWDER, FOR SOLUTION | Apotex | 10 VIAL, SINGLE-USE in 1 CARTON (60505-614... | 2 g/1 | 80 | $32.32 | $2.700 | ● Active | CMS + PDAC |
| 00781-3208-85 | Ceftriaxone Sodium 1 g/1 INJECTION, POWDER, FOR SOLUTION | Sandoz | 1 VIAL, SINGLE-USE in 1 CARTON (0781-3208-... | 1 g/1 | 4 | $1.62 | $3.450 | ● Active | CMS ASP |
| 60505-6148-00 | Ceftriaxone Sodium 1 g/1 INJECTION, POWDER, FOR SOLUTION | Apotex | 1 VIAL, SINGLE-USE in 1 CARTON (60505-6148... | 1 g/1 | 4 | $1.62 | $3.450 | ● Active | PDAC |
| 00143-9678-01 | Ceftriaxone 10 g/1 INJECTION, POWDER, FOR SOLUTION | Hikma | 1 INJECTION, POWDER, FOR SOLUTION in 1 CAR... | 10 g/1 | 40 | $16.16 | — | ● Active | CMS + PDAC |
| 00143-9856-25 | Ceftriaxone 2 g/1 INJECTION, POWDER, FOR SOLUTION | Hikma | 25 VIAL in 1 BOX (0143-9856-25) / 1 INJEC... | 2 g/1 | 200 | $80.80 | — | ● Active | CMS ASP |
| 00143-9858-25 | Ceftriaxone 500 mg/1 INJECTION, POWDER, FOR SOLUTION | Hikma | 25 VIAL in 1 BOX (0143-9858-25) / 1 INJEC... | 500 mg/1 | 50 | $20.20 | — | ● Active | CMS ASP |
| 00143-9859-25 | Ceftriaxone 250 mg/1 INJECTION, POWDER, FOR SOLUTION | Hikma | 25 VIAL in 1 BOX (0143-9859-25) / 1 INJEC... | 250 mg/1 | 25 | $10.10 | — | ● Active | CMS ASP |
| 00264-3153-11 | CEFTRIAXONE AND DEXTROSE 1 g/50mL INJECTION, SOLUTION | B. | 24 CONTAINER in 1 CASE (0264-3153-11) / 5... | 1 g/50mL | 96 | $38.78 | — | ● Active | CMS + PDAC |
| 00264-3155-11 | CEFTRIAXONE AND DEXTROSE 2 g/50mL INJECTION, SOLUTION | B. | 24 CONTAINER in 1 CASE (0264-3155-11) / 5... | 2 g/50mL | 192 | $77.57 | — | ● Active | CMS + PDAC |
| 00338-5002-41 | Ceftriaxone 1 g/50mL INJECTION, SOLUTION | Baxter | 24 BAG in 1 CASE (0338-5002-41) / 50 mL i... | 1 g/50mL | 96 | $38.78 | — | ● Active | CMS + PDAC |
| 00338-5003-41 | Ceftriaxone 2 g/50mL INJECTION, SOLUTION | Baxter | 24 BAG in 1 CASE (0338-5003-41) / 50 mL i... | 2 g/50mL | 192 | $77.57 | — | ● Active | CMS + PDAC |
| 00409-7333-04 | Ceftriaxone Sodium 1 g/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7333... | 1 g/1 | 40 | $16.16 | — | ● Active | CMS + PDAC |
| 00409-7333-49 | Ceftriaxone Sodium 1 g/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7333... | 1 g/1 | 40 | $16.16 | — | ● Active | CMS + PDAC |
| 00409-7334-10 | Ceftriaxone Sodium 10 g/100mL INJECTION, POWDER, FOR SOLUTION | Hospira, | 1 VIAL, PHARMACY BULK PACKAGE in 1 CARTON... | 10 g/100mL | 40 | $16.16 | — | ● Active | CMS + PDAC |
| 00409-7334-20 | Ceftriaxone Sodium 10 g/100mL INJECTION, POWDER, FOR SOLUTION | Hospira, | 1 VIAL, PHARMACY BULK PACKAGE in 1 CARTON... | 10 g/100mL | 40 | $16.16 | — | ● Active | CMS + PDAC |
| 00409-7336-04 | Ceftriaxone Sodium 2 g/1 INJECTION, POWDER, FOR SOLUTION | Hospira, | 10 VIAL, SINGLE-USE in 1 CARTON (0409-7336... | 2 g/1 | 80 | $32.32 | — | ● Active | CMS + PDAC |
| 00781-3210-46 | Ceftriaxone Sodium 10 g/100mL INJECTION, POWDER, FOR SOLUTION | Sandoz | 1 VIAL, PHARMACY BULK PACKAGE in 1 CARTON... | 10 g/100mL | 40 | $16.16 | — | ● Active | CMS + PDAC |
| 25021-0105-10 | Ceftriaxone | Sagent | — | — | 50 | $20.20 | — | — | CMS ASP |
| 25021-0105-66 | Ceftriaxone | Sagent | — | — | 50 | $20.20 | — | — | CMS ASP |
| 25021-0106-67 | Ceftriaxone | Sagent | — | — | 100 | $40.40 | — | — | CMS ASP |
| 25021-0107-20 | ceftriaxone 2 g/1 INJECTION, POWDER, FOR SOLUTION | Sagent | 25 VIAL in 1 CARTON (25021-107-20) / 1 IN... | 2 g/1 | 200 | $80.80 | — | ● Active | CMS ASP |
| 25021-0107-68 | Ceftriaxone | Sagent | — | — | 200 | $80.80 | — | — | CMS ASP |
| 25021-0108-69 | Ceftriaxone | Sagent | — | — | 40 | $16.16 | — | — | CMS ASP |
| 25021-0108-99 | Ceftriaxone | Sagent | — | — | 40 | $16.16 | — | — | CMS ASP |
| 44567-0700-25 | Ceftriaxone 500 mg/1 INJECTION, POWDER, FOR SOLUTION | WG | 25 VIAL in 1 CARTON (44567-700-25) / 1 IN... | 500 mg/1 | 50 | $20.20 | — | ● Active | CMS ASP |
| 44567-0702-25 | Ceftriaxone 2 g/1 INJECTION, POWDER, FOR SOLUTION | WG | 25 VIAL in 1 CARTON (44567-702-25) / 1 IN... | 2 g/1 | 200 | $80.80 | — | ● Active | CMS ASP |
| 44567-0702-95 | Ceftriaxone 2 g/1 INJECTION, POWDER, FOR SOLUTION | WG | 25 VIAL in 1 CARTON (44567-702-95) / 1 IN... | 2 g/1 | 200 | $80.80 | — | ● Active | CMS + PDAC |
| 44567-0703-01 | Ceftriaxone 10 g/1 INJECTION, POWDER, FOR SOLUTION | WG | 1 VIAL, PHARMACY BULK PACKAGE in 1 CARTON... | 10 g/1 | 40 | $16.16 | — | ● Active | CMS ASP |
| 50090-0944-00 | Ceftriaxone Sodium 500 mg/1 INJECTION, POWDER, FOR SOLUTION | A-S | 10 VIAL, SINGLE-USE in 1 CARTON (50090-094... | 500 mg/1 | 20 | $8.08 | — | ● Active | CMS ASP |
| 50090-0945-00 | Ceftriaxone | A-S | — | — | 40 | $16.16 | — | — | CMS ASP |
| 50090-1875-00 | Ceftriaxone Sodium 250 mg/1 INJECTION, POWDER, FOR SOLUTION | A-S | 10 VIAL, SINGLE-USE in 1 CARTON (50090-187... | 250 mg/1 | 10 | $4.04 | — | ● Active | CMS ASP |
| 50090-2444-00 | Ceftriaxone Sodium 250 mg/1 INJECTION, POWDER, FOR SOLUTION | A-S | 10 VIAL, SINGLE-USE in 1 CARTON (50090-244... | 250 mg/1 | 1 | $0.40 | — | ● Active | CMS ASP |
| 50090-3810-01 | Ceftriaxone | A-S | — | — | 40 | $16.16 | — | — | CMS ASP |
| 50090-3838-00 | Ceftriaxone Sodium 500 mg/1 INJECTION, POWDER, FOR SOLUTION | A-S | 1 VIAL, SINGLE-USE in 1 CARTON (50090-3838... | 500 mg/1 | 2 | $0.81 | — | ● Active | CMS ASP |
| 50090-4689-00 | Ceftriaxone | A-S | — | — | 10 | $4.04 | — | — | CMS ASP |
| 60505-6150-05 | Ceftriaxone Sodium 10 g/1 INJECTION, POWDER, FOR SOLUTION | Apotex | 1 VIAL, PHARMACY BULK PACKAGE in 1 CARTON... | 10 g/1 | 40 | $16.16 | — | ● Active | CMS + PDAC |
| 66794-0211-42 | Ceftriaxone | Piramal | — | — | 25 | $10.10 | — | — | CMS + PDAC |
| 66794-0212-42 | Ceftriaxone | Piramal | — | — | 50 | $20.20 | — | — | CMS + PDAC |
| 66794-0214-42 | Ceftriaxone | Piramal | — | — | 200 | $80.80 | — | — | CMS + PDAC |
| 66794-0215-15 | Ceftriaxone | Piramal | — | — | 40 | $16.16 | — | — | CMS + PDAC |
| 72572-0062-25 | Ceftriaxone 2 g/1 INJECTION, POWDER, FOR SOLUTION | Civica, | 25 VIAL in 1 BOX (72572-062-25) / 1 INJEC... | 2 g/1 | 200 | $80.80 | — | ● Active | CMS + PDAC |
| 60505-6149-00 | CEFTRIAXONE (CRYSTALLINE) 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 64679-0703-01 | CEFTRIAXONE (USP) 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 64679-0702-02 | CEFTRIAXONE (USP) 500 MG | Unknown | — | — | 2 | $0.81 | — | — | PDAC |
| 64679-0701-02 | CEFTRIAXONE (USP) 250 MG | Unknown | — | — | 1 | $0.40 | — | — | PDAC |
| 10019-0688-27 | CEFTRIAXONE (USP) 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 10019-0689-05 | CEFTRIAXONE (USP,PHARMACY BULK) 10 GM | Unknown | — | — | 40 | $16.16 | — | — | PDAC |
| 64679-0983-02 | CEFTRIAXONE (USP) 1 GM | Unknown | — | — | 4 | $1.62 | — | — | PDAC |
| 68180-0644-01 | CEFTRIAXONE 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 10019-0688-04 | CEFTRIAXONE 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 66794-0213-42 | CEFTRIAXONE (PF,LATEX-FREE) 1 GM | Unknown | — | — | 4 | $1.62 | — | — | PDAC |
| 60505-0750-01 | CEFTRIAXONE (SDV, USP,CRYSTALLINE) 250 MG | Unknown | — | — | 1 | $0.40 | — | — | PDAC |
| 68330-0006-01 | CEFTRIAXONE (USP,PIGGYBACK) 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 68330-0005-01 | CEFTRIAXONE (USP,PIGGYBACK) 1 GM | Unknown | — | — | 4 | $1.62 | — | — | PDAC |
| 68330-0002-10 | CEFTRIAXONE (USP) 500 MG | Unknown | — | — | 2 | $0.81 | — | — | PDAC |
| 68330-0002-01 | CEFTRIAXONE (USP) 500 MG | Unknown | — | — | 2 | $0.81 | — | — | PDAC |
| 68330-0001-10 | CEFTRIAXONE (USP) 250 MG | Unknown | — | — | 1 | $0.40 | — | — | PDAC |
| 68330-0001-01 | CEFTRIAXONE (USP) 250 MG | Unknown | — | — | 1 | $0.40 | — | — | PDAC |
| 68330-0003-01 | CEFTRIAXONE (USP) 1 GM | Unknown | — | — | 4 | $1.62 | — | — | PDAC |
| 68330-0003-10 | CEFTRIAXONE (USP) 1 GM | Unknown | — | — | 4 | $1.62 | — | — | PDAC |
| 68330-0004-01 | CEFTRIAXONE (USP) 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 68330-0004-10 | CEFTRIAXONE (USP) 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 00781-9329-90 | CEFTRIAXONE NOVAPLUS 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 63323-0347-20 | CEFTRIAXONE (S.D.V.) 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 60505-0679-05 | CEFTRIAXONE (1X100ML,BULK PKG) 10 GM | Unknown | — | — | 40 | $16.16 | — | — | PDAC |
| 60505-0750-04 | CEFTRIAXONE (10X10ML) 250 MG | Unknown | — | — | 1 | $0.40 | — | — | PDAC |
| 60505-0750-00 | CEFTRIAXONE (1X10ML) 250 MG | Unknown | — | — | 1 | $0.40 | — | — | PDAC |
| 68180-0644-10 | CEFTRIAXONE 2 GM | Unknown | — | — | 8 | $3.23 | — | — | PDAC |
| 68180-0633-10 | CEFTRIAXONE 1 GM | Unknown | — | — | 4 | $1.62 | — | — | PDAC |
| 68180-0633-01 | CEFTRIAXONE 1 GM | Unknown | — | — | 4 | $1.62 | — | — | PDAC |
| 68180-0622-10 | CEFTRIAXONE 500 MG | Unknown | — | — | 2 | $0.81 | — | — | PDAC |
| 68180-0622-01 | CEFTRIAXONE 500 MG | Unknown | — | — | 2 | $0.81 | — | — | PDAC |
| 68180-0611-10 | CEFTRIAXONE 250 MG | Unknown | — | — | 1 | $0.40 | — | — | PDAC |
| 68180-0611-01 | CEFTRIAXONE 250 MG | Unknown | — | — | 1 | $0.40 | — | — | PDAC |
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$239.8K
Claims
127,950
Beneficiaries
98,586
Spend / beneficiary
$2.43
Spend / claim
$1.87
Trend by period
Where J0696 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #511 of 824
#506
CYCLOPHOSPHAMIDE(J90... J9071
$255.9K
#507
ERTAPENEM J1335
$254.7K
#508
SURGRAFT TL, PER SQ... Q4263
$246.1K
#509
CAMPTOSAR* J9206
$245.5K
#510
EPIEFFECT, PER SQ CM... Q4278
$240.8K
#511
CEFTRIAXONE J0696
$239.8K
#512
KHAPZORY J0642
$235.8K
#513
CYCLOPHOSPHAMIDE(J85... J8530
$233.2K
#514
LEUKINE J2820
$227.5K
#515
OPTISON Q9956
$225.5K
#516
BRIXADI(J0578) J0578
$220.9K
Total claims — #18 of 824
#13
FLUAD * 90653
164,538
#14
EYLEA J0178
144,294
#15
LEXISCAN* J2785
142,015
#16
PROGRAF(J7507)* J7507
130,100
#17
EYLEA HD J0177
128,412
#18
CEFTRIAXONE J0696
127,950
#19
MNEXSPIKE (12Y UP) 91323
127,684
#20
CAPVAXIVE 90684
110,351
#21
KEYTRUDA J9271
108,081
#22
PAVBLU Q5147
107,941
#23
EVENITY (2 SYRINGES) J3111
106,087
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $239.8K | 98,586 | 127,950 | $2.43 | $1.87 |
| 2025 (Q1-Q4) | $1.02M | 351,874 | 547,063 | $2.91 | $1.87 |
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.
📈 Medicare Part B claims detail CMS PSPS · 2024
Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$1.03M
Medicare paid
$720.9K
Submitted services
3,045,506
Denial rate
26.3%
Allowed / service
$0.46
Submitted charges
$54.15M
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.
🗺️ Where J0696 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 1,690,631 services across 55 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.
📊 What bills under J0696
J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.
NDC products by ingredient
NDC products by labeler
🗃️ Data sources & freshness
Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
99 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.
⚠️ Practical billing caveats
- A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
- Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
- Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
- Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
- The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
- Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.
❓ J0696 billing FAQ
What is HCPCS code J0696?
J0696 is a HCPCS Level II J-code used to bill Injection, ceftriaxone sodium, per 250 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J0696?
One unit of J0696 represents 250 MG. Report the number of units equal to the dose administered divided by 250 MG.
How many units of J0696 should I bill?
Divide the dose administered by the code's unit size (250 MG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J0696?
The Medicare Part B payment limit is $0.404 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.396 per unit. Payment limits are revised quarterly.
Which NDCs bill under J0696?
99 NDCs currently map to J0696 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J0696 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.