RAPAMUNE J Code: J7520

Drug & Product Overview

HCPCS Descriptor Sirolimus, oral, 1 mg

HCPCS Added Date January 1, 2001

Manufacturer Multiple Manufacturers

Route of Administration Oral

Generic Status Multi-Source; Generic

Dosage Form Not Available | Solution | Tablet | Tablet, Film Coated | Tablet, Sugar Coated

About RAPAMUNE

Rapamune is a medication aligned to the HCPCS J Code: J7520 for billing, pricing, and reimbursement purposes in the United States. Classified under Immunosuppressant, it is administered via the oral route and manufactured by multiple companies.

According to CMS Drug Use Information: Sirolimus is used with other medications to prevent rejection of a kidney transplant. This medication belongs to a class of drugs known as immunosuppressants. It works by weakening your body's defense system (immune system) to help your body accept the new organ as if it were your own. Sirolimus may also be used to treat a certain lung disease (lymphangioleiomyomatosis-LAM).

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 29 NDCs — log in for the full crosswalk.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
00008-1041-05	Rapamune	Pfizer Inc	100	1 MG
16714-0187-01	sirolimus	NORTHSTAR RX LLC	50	.5 MG
50268-0718-13	Sirolimus	Avpak	30	1 MG
55111-0653-01	Sirolimus	Dr. Reddy's Laboratories Limited	100	1 MG
59762-1001-01	Sirolimus	Mylan Pharmaceuticals Inc.	50	.5 MG
•••••-••••-•• Log in to view	RAPAMUNE
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RAPAMUNE Pricing & Reimbursement

J7520 Private Payer Reimbursement

$0.98 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

RAPAMUNE Medically Unlikely Edits (MUE)

The most billing units of J7520 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg. The limit is different in the office and the hospital. Use the one for your setting.

Practitioner Office

0 units / day

Not payable in this setting

Hospital Outpatient

40 units / day

= 40 mg 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 →

Not on the CMS JW / JZ list

CMS does not include Rapamune (J7520) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J7520. Wastage billing guide →

RAPAMUNE 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.

Lymphangioleiomyomatosis Organ Rejection in Renal Transplantation Prophylaxis of Organ Rejection in Renal Transplantation Prophylaxis of organ rejection in renal transplantation

Drug Class

Decreased Immunologic Activity [PE]Kinase Inhibitor [EPC]Protein Kinase Inhibitors [MoA]mTOR Inhibitor Immunosuppressant [EPC]mTOR Inhibitors [MoA]

Frequently Asked Questions

Is there an available Rapamune billing and coding guide?

Our team has not identified a manufacturer-published source of billing and coding information for RAPAMUNE.

Are there any available Rapamune patient assistance programs?

Our team has not identified a manufacturer-published source of patient assistance information for RAPAMUNE.

Where can I find Rapamune prescribing information?

RAPAMUNE prescribing information can be found at the link below. Please reach out to us if you believe this information to be innacurate or out of date. Visit Here →

Where can I find Rapamune side effect information?

Our team has not yet identified a source of side effects information for RAPAMUNE. Please check back in a few weeks.

Does billing RAPAMUNE require JZ/JW wastage modifiers?

CMS does not include RAPAMUNE (J7520) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J7520. For more information, visit the link below.

About BuyandBill.com:

The BuyandBill.com team is dedicated to delivering high-quality coding and billing information for office-administered drugs. We continuously research HCPCS-coded medications to expand our resources and ensure data accuracy. Manufacturers: click here to sponsor your medication, and we will ensure the most accurate and detailed information is displayed.