CEFTRIAXONE J Code: J0696
Injection, ceftriaxone sodium, per 250 mg
Q4 2026 Medicare Payment Limit for J0696, effective October 1, 2026: $0.39 per HCPCS billing unit, down 3.5% from $0.404. From CMS's final file.
Drug & Product Overview
About CEFTRIAXONE
Ceftriaxone is a medication aligned to the HCPCS J Code: J0696 for billing, pricing, and reimbursement purposes in the United States. This Antibiotic medication is administered via the intramuscular or intravenous routes and manufactured by multiple companies.
According to CMS Drug Use Information: Ceftriaxone is used to treat a wide variety of bacterial infections. This medication belongs to a class of drugs known as cephalosporin antibiotics. It works by stopping the growth of bacteria. This drug is not recommended for use in newborns with high blood bilirubin levels and premature infants due to increased risk of side effects. Ask the doctor or pharmacist for details.
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 80 NDCs — log in for the full crosswalk.
| NDC Code | Drug | Manufacturer | Billing Units / Pkg | Package Size |
|---|---|---|---|---|
| 00143-9678-01 | Ceftriaxone | Hikma Pharmaceuticals USA Inc. | 40 | Ceftriaxone Intravenou s Injection 10 G… Login for More |
| 00264-3153-11 | Ceftriaxone And Dextrose | B. Braun Medical Inc. | 96 | 1000 MG / 50 ML |
| 00338-5002-41 | Ceftriaxone | Baxter Healthcare Company | 96 | 1000 MG / 50 ML |
| 00409-7332-01 | Ceftriaxone Sodium | Hospira, Inc | 40 | Ceftriaxone Sodium Int ramuscular Injec… Login for More |
| 00781-3206-85 | Ceftriaxone Sodium | Sandoz Inc | 1 | 250 MG |
| •••••-••••-•• Log in to view | CEFTRIAXONE | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | CEFTRIAXONE | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
| •••••-••••-•• Log in to view | CEFTRIAXONE | •••••••••••• Log in to view | •••• Log in to view | ••• •• / • •• Log in to view |
CEFTRIAXONE Pricing & Reimbursement
National median reimbursement across major commercial payers.
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Login to use the calculator →CEFTRIAXONE 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) |
| 96372 Login for More | Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular Login for More |
CMS does not include Ceftriaxone (J0696) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J0696. Wastage billing guide →
CEFTRIAXONE Medically Unlikely Edits (MUE)
The most billing units of J0696 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 250 mg.
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 →
CEFTRIAXONE Clinical Information
Indications and drug classification.
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.
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Frequently Asked Questions
Is there an available Ceftriaxone billing and coding guide?
Are there any available Ceftriaxone patient assistance programs?
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Does billing CEFTRIAXONE require JZ/JW wastage modifiers?
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