APIDRA J Code: J1815

Self-Administered Drug Exclusion 7 Medicare Administrative Contractors list J1815 as usually self-administered and exclude it from Part B coverage in their jurisdictions. Check the article for your MAC before billing: CGS, First Coast, Noridian (A53032), Noridian (A53033), Novitas, Palmetto, Wellpoint Federal, WPS · All SAD lists →

Drug & Product Overview

HCPCS Descriptor Injection, insulin, per 5 units

HCPCS Added Date January 1, 2003

Manufacturer Multiple Manufacturers

Route of Administration Intravenous, Subcutaneous

Generic Status Multi-Source; Generic

Dosage Type Single-Dose, Multi-Dose

Dosage Form Injection, Solution | Injection, Suspension

About APIDRA

Apidra is a medication aligned to the HCPCS J Code: J1815 for billing, pricing, and reimbursement purposes in the United States. This Insulin medication is administered via the intravenous or subcutaneous routes and manufactured by multiple companies.

Manufacturers, reach out to us to add more information.

NDC Code Information

21 NDC packages are crosswalked to J1815. Package detail is available to logged-in subscribers.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
•••••-••••-•• Log in to view	APIDRA
	APIDRA
	APIDRA
	APIDRA

Login to view 21 NDC packages View pricing, complete NDC-to-HCPCS alignments, and package details.

APIDRA Pricing & Reimbursement

J1815 Private Payer Reimbursement

$0.22 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

Biosimilar Information

APIDRA Approval Date: October 28, 1982

Product Name	HCPCS Code	Active Ingredient	BLA Type
FIASP	J1815	Insulin Aspart	351(a) Originator Product
NOVOLOG	J1817	Insulin Aspart	351(a) Originator Product
KIRSTY	N/A	Insulin Aspart	351(K) Interchangeable
MERILOG	N/A	Insulin Aspart	351(K) Biosimilar

APIDRA CPT Administration Codes

CPT Code	Description
96372	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular

Not on the CMS JW / JZ list

CMS does not include Apidra (J1815) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1815. Wastage billing guide →

APIDRA Medically Unlikely Edits (MUE)

The most billing units of J1815 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 5 units. The limit is different in the office and the hospital. Use the one for your setting.

Practitioner Office

8 units / day

= 40 units per day

Hospital Outpatient

200 units / day

= 1,000 units 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 →

APIDRA 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.

Diabetes mellitus diabetes mellitus

Drug Class

Insulin Analog [EPC]Insulin [CS]Insulin [Chemical/Ingredient]Insulin [EPC]

Frequently Asked Questions

Is there an available Apidra billing and coding guide?

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

Are there any available Apidra patient assistance programs?

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

Where can I find Apidra prescribing information?

APIDRA 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 Apidra side effect information?

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

Does billing APIDRA require JZ/JW wastage modifiers?

CMS does not include APIDRA (J1815) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J1815. For more information, visit the link below.

About BuyandBill.com:

The BuyandBill.com team is dedicated to delivering high-quality coding and billing information for office-administered drugs. We continuously research HCPCS-coded medications to expand our resources and ensure data accuracy. Manufacturers: click here to sponsor your medication, and we will ensure the most accurate and detailed information is displayed.