Home Drug Codes J Codes J0597 · BERINERT
Updated July 1st, 2026

BERINERT J Code: J0597

Injection, c-1 esterase inhibitor (human), berinert, 10 units

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Q4 2026 Medicare Payment Limit for J0597, effective October 1, 2026: $79.329 per HCPCS billing unit, up 0.1% from $79.262. From CMS's final file.

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Medicare Payment Limit ?
$79.262
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$79.262
/ HCPCS billing unit · APC 9269
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
1
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Drug & Product Overview

HCPCS Descriptor Injection, c-1 esterase inhibitor (human), berinert, 10 units
HCPCS Added Date January 1, 2011
Manufacturer CSL Behring
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Kit

About BERINERT

Berinert is a medication aligned to the HCPCS J Code: J0597 for billing, pricing, and reimbursement purposes in the United States. This Immunology medication is administered via the intravenous route and manufactured by CSL Behring.

According to CMS Drug Use Information: This medication is used to treat the swelling problems that occur with a certain immune disease passed down through families (hereditary angioedema-HAE). HAE is caused by low levels or improper function of a natural substance produced by the body (C1-inhibitor). Symptoms such as rapid swelling of the hands, feet, limbs, face, tongue, or throat can occur. Swelling of the intestinal tract may cause symptoms such as abdominal cramps, diarrhea, or vomiting. Attacks of swelling may occur without reason. However, anxiety, stress, sickness, and surgery may trigger attacks in some people. This medication increases the level of C1-inhibitor to help treat attacks of sudden swelling due to hereditary angioedema.

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
63833-0825-02 Berinert CSL Behring GmbH 50 Kit
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BERINERT Pricing & Reimbursement

J0597 Private Payer Reimbursement
$76.00 / 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

BERINERT 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)
JW / JZ modifiers apply

CMS has identified Berinert (J0597) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

BERINERT Medically Unlikely Edits (MUE)

The most billing units of J0597 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 10 units.

Practitioner Office & Hospital Outpatient
250 units / day
= 2,500 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 →

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

BERINERT 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.

Hereditary Angioedema (HAE) — acute abdominal, facial, or laryngeal attacks

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Frequently Asked Questions

Is there an available Berinert billing and coding guide?
Billing and coding information for BERINERT can be found through CSL Behring. Visit Here →
Are there any available Berinert patient assistance programs?
BERINERT patient assistance information can be found through CSL Behring. Visit Here →
Where can I find Berinert prescribing information?
BERINERT prescribing information can be found at the link below: Visit Here →
Where can I find Berinert side effect information?
Information regarding BERINERT's side effects can be found at MedlinePlus Visit Here →
Does billing BERINERT require JZ/JW wastage modifiers?
CMS has identified BERINERT(J0597) 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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