Home › Drug Codes › J Codes › J0295 · Ampicillin-Sulbactam
Updated July 1st, 2026

Ampicillin-Sulbactam J Code: J0295

Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm

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Q4 2026 Medicare Payment Limit for J0295, effective October 1, 2026: $1.457 per HCPCS billing unit, up 0.4% from $1.451. From CMS's final file.

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Medicare Payment Limit ?
$1.451
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
Not published
CMS publishes none for Q3 2026
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
72
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Drug & Product Overview

HCPCS Descriptor Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm
HCPCS Added Date January 1, 1995
Manufacturer Multiple Manufacturers
Route of Administration Intramuscular, Intravenous
Generic Status Multi-Source; Generic
Dosage Type Single-Dose
Dosage Form Injection, Powder, For Solution | Not Available

About Ampicillin-Sulbactam

Ampicillin-sulbactam is a medication aligned to the HCPCS J Code: J0295 for billing, pricing, and reimbursement purposes in the United States. It is an Antibiotic drug administered via the intramuscular or intravenous routes and manufactured by multiple companies.

According to CMS Drug Use Information: This combination medication is used to treat a wide variety of bacterial infections. It is known as a penicillin-type antibiotic. It works by stopping the growth of bacteria.

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 72 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
00049-0013-83 Unasyn Roerig 10 Unasyn Intramuscular I njection 1 G/1 -… Login for More
00409-2689-01 Ampicillin and Sulbactam Hospira, Inc 10 Ampicillin and Sulbact am Intravenous I… Login for More
00409-2987-03 Ampicillin-Sulbactam Pfizer Inc 20 Ampicillin and Sulbact am Intravenous I… Login for More
00641-6116-10 Ampicillin and Sulbactam Hikma Pharmaceuticals USA Inc. 10 Ampicillin and Sulbact am Intravenous I… Login for More
25021-0142-20 ampicillin and sulbactam Sagent Pharmaceuticals 10 ampicillin and sulbact am Intramuscular… Login for More
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Ampicillin-Sulbactam
Ampicillin-Sulbactam
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Ampicillin-Sulbactam Pricing & Reimbursement

J0295 Private Payer Reimbursement
$1.30 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

Ampicillin-Sulbactam CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

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 Ampicillin-sulbactam (J0295) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J0295. Wastage billing guide →

Ampicillin-Sulbactam Medically Unlikely Edits (MUE)

The most billing units of J0295 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1.5 gm.

Practitioner Office & Hospital Outpatient
12 units / day
= 18 gm 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 →

gm Enter a dose to see how many billing units it is and whether it is under the limit.

Ampicillin-Sulbactam 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.

Gynecological Infections Intra-Abdominal Infections Skin and Skin Structure Infections
Drug Class
Penicillin-class Antibacterial [EPC]Penicillins [CS]beta Lactamase Inhibitor [EPC]beta Lactamase Inhibitors [MoA]

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Frequently Asked Questions

Is there an available Ampicillin-Sulbactam billing and coding guide?
We have not yet identified a manufacturer source of Ampicillin-Sulbactam billing and coding information.
Are there any available Ampicillin-Sulbactam patient assistance programs?
Our team did not identify a source for Ampicillin-Sulbactam patient assistance information. Please reach out to our team if you feel that this is a mistake.
Where can I find Ampicillin-Sulbactam prescribing information?
Our team is still working to identify a prescribing information source for Ampicillin-Sulbactam
Where can I find Ampicillin-Sulbactam side effect information?
Our team has not yet identified a source of side effects information for Ampicillin-Sulbactam. Please check back in a few weeks.
Does billing Ampicillin-Sulbactam require JZ/JW wastage modifiers?
CMS does not include Ampicillin-Sulbactam (J0295) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J0295. For more information, visit the link below.

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