ACYCLOVIR SODIUM J Code: J0133

Drug & Product Overview

HCPCS Descriptor Injection, acyclovir, 5 mg

HCPCS Added Date January 1, 2006

Manufacturer Multiple Manufacturers

Route of Administration Intravenous

Generic Status Multi-Source; Generic

Dosage Type Single-Dose

Dosage Form Injection, Solution

About ACYCLOVIR SODIUM

Acyclovir Sodium is a medication aligned to the HCPCS J Code: J0133 for billing, pricing, and reimbursement purposes in the United States. It is an Antiviral drug administered via the intravenous route and manufactured by multiple companies.

According to CMS Drug Use Information: This medication is used in certain people to treat outbreaks of herpes simplex infection of the skin (such as on the genitals), mucous membrane areas (such as the mouth, nose), or brain. It is also used in certain people to treat shingles infection. The viruses that cause these infections live in the body quietly until an outbreak occurs. Acyclovir does not cure these infections, but can speed healing of the sores, decrease pain/itching/formation of new sores, and lower the risk of other problems from the virus (such as infection spreading to other parts of the body/organs, pain even after the sores heal).

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. Showing 5 of 14 NDCs — log in for the full crosswalk.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
55150-0154-10	Acyclovir Sodium	Eugia Us Llc	1000	500 MG / 10 ML
55150-0155-20	Acyclovir Sodium	Eugia Us Llc	2000	1000 MG / 20 ML
63323-0325-10	Acyclovir	Fresenius Kabi USA, LLC	1000	500 MG / 10 ML
63323-0325-14	Acyclovir	Fresenius Kabi USA, LLC	1000	500 MG / 10 ML
70436-0030-82	acyclovir	Slate Run Pharmaceuticals, LLC	1000	500 MG / 10 ML
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ACYCLOVIR SODIUM Pricing & Reimbursement

J0133 Private Payer Reimbursement

$0.34 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

ACYCLOVIR SODIUM CPT Administration Codes

CPT Code	Description
96365	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366	Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)

Not on the CMS JW / JZ list

CMS does not include Acyclovir Sodium (J0133) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J0133. Wastage billing guide →

ACYCLOVIR SODIUM Medically Unlikely Edits (MUE)

The most billing units of J0133 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 5 mg.

Practitioner Office & Hospital Outpatient

1,200 units / day

= 6,000 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

ACYCLOVIR SODIUM Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Herpes Genitalis (Severe Initial Clinical Episodes) Herpes Simplex (HSV-1 and HSV-2) Infections in Immunocompromised Patients Herpes Simplex Encephalitis Herpes Simplex Infections in Immunocompromised Patients Initial Episodes of Herpes Genitalis Mucosal and Cutaneous Herpes Simplex (HSV-1 and HSV-2) Infections in Immunocompromised Patients Neonatal Herpes Simplex Virus Infection Neonatal Herpes Simplex Virus Infections Severe Initial Clinical Episodes of Herpes Genitalis Varicella-Zoster (Shingles) Infections in Immunocompromised Patients Varicella-Zoster Infections in Immunocompromised Patients

Drug Class

DNA Polymerase Inhibitors [MoA]Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor [EPC]Herpesvirus Nucleoside Analog DNA Polymerase Inhibitor [EPC]Nucleoside Analog [EXT]

Frequently Asked Questions

Is there an available Acyclovir Sodium billing and coding guide?

We have not yet identified a manufacturer source of Acyclovir Sodium billing and coding information.

Are there any available Acyclovir Sodium patient assistance programs?

Our team did not identify a source for Acyclovir Sodium patient assistance information. Please reach out to our team if you feel that this is a mistake.

Where can I find Acyclovir Sodium prescribing information?

ACYCLOVIR SODIUM prescribing information can be found at the link below. Please reach out to us if you believe this information to be innacurate or out of date. Visit Here →

Where can I find Acyclovir Sodium side effect information?

Our team has not yet identified a source of side effects information for ACYCLOVIR SODIUM. Please check back in a few weeks.

Does billing ACYCLOVIR SODIUM require JZ/JW wastage modifiers?

CMS does not include ACYCLOVIR SODIUM (J0133) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J0133. For more information, visit the link below.

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