Fresenius Kabi

POLOCAINE - Cost

Last Updated: April 1st, 2024

HCPCS:

J0670

HCPCS Code Descriptor:

Injection, mepivacaine hydrochloride, per 10 ml

Medicare Payment Limit:

The POLOCAINE Medicare Payment Limit is $3.557

Average Sale Price:

POLOCAINE ASP cost available once logged in.

Medicare Co-Insurance Percentage:

The POLOCAINE Medicare Co-insurance percentage is 20%. POLOCAINE's Medicare Co-insurance amount is $0.71 per HCPCS unit.

APC Code:

The Polocaine APC Code is: not available

APC Payment Limit:

The APC Payment Limit for POLOCAINE is not available.

Polocaine Cost Information:

POLOCAINE, a product of Fresenius Kabi, became effective on January 1, 1997 and is associated with HCPCS J0670. There are six NDCs mapped to J0670. Between 2020 and 2023, pricing remained relatively constant with minor changes in AWP and WAC. Conversely, ASP has been more frequently volatile with positive and negative trends. Through 2024, ASP has been slightly higher than WAC.

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Polocaine’s wholesale acquisition cost (WAC) information was last updated on:
March 5, 2024
Polocaine’s average wholesale price (AWP) information was last updated on:
March 5, 2024