AMBISOME J Code: J0289

Drug & Product Overview

HCPCS Descriptor Injection, amphotericin b liposome, 10 mg

HCPCS Added Date January 1, 2003

Manufacturer Multiple Manufacturers

Route of Administration Intravenous

Generic Status Multi-Source; Generic

Dosage Type Single-Dose

Dosage Form Injectable, Liposomal | Injection, Powder, Lyophilized, For Solution | Injection, Powder, Lyophilized, For Suspension

About AMBISOME

Ambisome is a medication aligned to the HCPCS J Code: J0289 for billing, pricing, and reimbursement purposes in the United States. It is an Anti-Fungal drug administered via the intravenous route and manufactured by multiple companies.

According to CMS Drug Use Information: This medication is used to treat a variety of serious fungal infections. It is often used in patients who cannot tolerate or who do not respond to the regular amphotericin treatment. It works by stopping the growth of fungi.

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. The list of NDCs below is not exhaustive.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
00469-3051-30	AmBisome	Astellas Pharma US, Inc.	5	50 MG / 12.5 ML
23155-0594-31	Amphotericin B	Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.	5	50 MG
55150-0365-01	Amphotericin B	Eugia US LLC	5	50 MG / 12.5 ML
62756-0233-01	Amphotericin B	Sun Pharmaceutical Industries, Inc.	5	50 MG
67457-0926-50	Amphotericin B liposome	Mylan Institutional LLC	5	50 MG / 12.5 ML

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AMBISOME Pricing & Reimbursement

J0289 Private Payer Reimbursement

$21.19 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

AMBISOME 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)

JW / JZ modifiers apply

CMS has identified Ambisome (J0289) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

AMBISOME Medically Unlikely Edits (MUE)

The most billing units of J0289 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 mg. The limit is different in the office and the hospital. Use the one for your setting.

Practitioner Office

50 units / day

= 500 mg per day

Hospital Outpatient

115 units / day

= 1,150 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 →

AMBISOME 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.

Cryptococcal Meningitis Cryptococcal Meningitis in HIV-infected patients Empirical therapy for presumed fungal infection in febrile, neutropenic patients Presumed fungal infection in febrile, neutropenic patients Systemic fungal infections (Aspergillus species, Candida species, Cryptococcus species) Systemic fungal infections (Aspergillus species, Candida species, and/or Cryptococcus species) refractory to amphotericin B deoxycholate or where renal impairment or unacceptable toxicity precludes its use Systemic fungal infections (Aspergillus species, Candida species, and/or Cryptococcus species) refractory to or intolerant of amphotericin B deoxycholate Systemic fungal infections (Aspergillus, Candida, Cryptococcus) refractory to or intolerant of amphotericin B deoxycholate Systemic fungal infections (Aspergillus, Candida, or Cryptococcus species) refractory to or intolerant of amphotericin B deoxycholate Visceral Leishmaniasis Visceral leishmaniasis

Drug Class

Lipid-based Polyene Antifungal [EPC]Polyene Antifungal [EPC]Polyenes [CS]

Frequently Asked Questions

Is there an available Ambisome billing and coding guide?

Our team has not identified a manufacturer-published source of billing and coding information for AMBISOME.

Are there any available Ambisome patient assistance programs?

Our team has not identified a manufacturer-published source of patient assistance information for AMBISOME.

Where can I find Ambisome prescribing information?

Our team is still working to identify a prescribing information source for AMBISOME

Where can I find Ambisome side effect information?

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

Does billing AMBISOME require JZ/JW wastage modifiers?

CMS has identified AMBISOME(J0289) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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