Home Drug Codes J Codes J2516 · PENTAMIDINE ISETHIONATE
Updated July 1st, 2026

PENTAMIDINE ISETHIONATE J Code: J2516

Injection, pentamidine isethionate, 1 mg

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Q4 2026 Medicare Payment Limit for J2516, effective October 1, 2026: $0.482 per HCPCS billing unit, up 201.2% from $0.16. From CMS's final file.

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Medicare Payment Limit ?
$0.16
/ 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 ?
5
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Drug & Product Overview

HCPCS Descriptor Injection, pentamidine isethionate, 1 mg
HCPCS Added Date January 1, 2026
Manufacturer Multiple Manufacturers
Route of Administration Intramuscular, Intravenous
Generic Status Multi-Source; Generic
Dosage Type Single-Dose
Dosage Form Injection, Powder, Lyophilized, For Solution

About PENTAMIDINE ISETHIONATE

Pentamidine Isethionate is a medication aligned to the HCPCS J Code: J2516 for billing, pricing, and reimbursement purposes in the United States. Classified under Anti-Fungal, it is administered via the intramuscular or intravenous routes and manufactured by multiple companies.

According to CMS Drug Use Information: Pentamidine given by inhalation is used to prevent a serious lung infection (Pneumocystis pneumonia-PCP) in people with acquired immunodeficiency syndrome (AIDS). Pentamidine belongs to a class of drugs known as antiprotozoals. It works by killing the organism that causes the infection.

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 2 of 5 NDCs — log in for the full crosswalk.

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PENTAMIDINE ISETHIONATE Pricing & Reimbursement

J2516 Private Payer Reimbursement
$0.24 / 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

Pentamidine Isethionate 505(b)(2) Information:

HCPCS Code Manufacturer Active Ingredient HCPCS Description
J2516 Generic Code (Multiple Manufacturers) Pentamidine Isethionate Injection, pentamidine isethionate, 1 mg

PENTAMIDINE ISETHIONATE 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
Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

PENTAMIDINE ISETHIONATE 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.

Pneumonia due to Pneumocystis carinii
Drug Class
Antiprotozoal [EPC]

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Frequently Asked Questions

Is there a manufacturer-published PENTAMIDINE ISETHIONATE billing and coding guide?
We have not identified a manufacturer-published source of billing and coding information for PENTAMIDINE ISETHIONATE. Please reach out to our team if you believe that this is a mistake.
Is there an available PENTAMIDINE ISETHIONATE patient assistance program?
Our team did not identify a source of patient assistance information for PENTAMIDINE ISETHIONATE. Please reach out if you believe that this is a mistake.
Where can I find PENTAMIDINE ISETHIONATE prescribing information?
We have not identified a source of prescribing information for PENTAMIDINE ISETHIONATE.
Where can I find PENTAMIDINE ISETHIONATE side effect information?
PENTAMIDINE ISETHIONATE side effect information can be found through MedlinePlus. Visit Here →
Does billing PENTAMIDINE ISETHIONATE require JZ/JW wastage modifiers?
CMS does not include PENTAMIDINE ISETHIONATE (J2516) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J2516. For more information, visit the link below.

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