Amgen

PROLIA - Cost

Last Updated: April 1st, 2024

HCPCS:

J0897

HCPCS Code Descriptor:

Injection, denosumab, 1 mg

Medicare Payment Limit:

The PROLIA Medicare Payment Limit is $25.189

Average Sale Price:

PROLIA ASP cost available once logged in.

Medicare Co-Insurance Percentage:

The PROLIA Medicare Co-insurance percentage is 19.586%. PROLIA's Medicare Co-insurance amount is $4.93 per HCPCS unit.

APC Code:

The Prolia APC Code is: 9272

APC Payment Limit:

The APC Payment Limit for PROLIA is available. Login to view.

Prolia Cost Information:

PROLIA, HCPCS J0897, became effective on January 1, 2012. PROLIA currently has two NDCs mapped to J Code: J0897. Overall, prices have shown a steady upward trend since 2016. Between 2022 and 2024, ASP rose an estimated 14% while WAC and AWP rose around 18% and 20% respectively.

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