ZOLGENSMA J Code: J3399

Drug & Product Overview

HCPCS Descriptor Injection, onasemnogene abeparvovec-xioi, per treatment, up to 5x10^15 vector genomes

HCPCS Added Date July 1, 2020

Manufacturer Novartis

Route of Administration Intravenous

Generic Status Single-Source; Branded

Dosage Form Kit

About ZOLGENSMA

Zolgensma is a medication aligned to the HCPCS J Code: J3399 for billing, pricing, and reimbursement purposes in the United States. This Genetic Disorder medication is administered via the intravenous route and manufactured by Novartis.

Manufacturers, reach out to us to add more information.

NDC Code Information

37 NDC packages are crosswalked to J3399. Package detail is available to logged-in subscribers.

NDC Code	Drug	Manufacturer	Billing Units / Pkg	Package Size
•••••-••••-•• Log in to view	ZOLGENSMA
	ZOLGENSMA
	ZOLGENSMA
	ZOLGENSMA

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ZOLGENSMA Pricing & Reimbursement

J3399 Private Payer Reimbursement

$640.33 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

Create an account on PayerPrice for more information →

ZOLGENSMA CPT Administration Codes

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)

Not on the CMS JW / JZ list

CMS does not include Zolgensma (J3399) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J3399. Wastage billing guide →

ZOLGENSMA Medically Unlikely Edits (MUE)

The most billing units of J3399 Medicare will pay for one patient in one day, as published by CMS. 1 unit = per tx dose (up to 5 x10^15 vg?).

Practitioner Office & Hospital Outpatient

1 unit / day

Same limit in both settings

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 →

ZOLGENSMA 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.

Spinal muscular atrophy

Frequently Asked Questions

Is there an available Zolgensma billing and coding guide?

Billing and coding information for ZOLGENSMA can be found through Novartis Gene Therapies. Visit Here →

Are there any available Zolgensma patient assistance programs?

ZOLGENSMA patient assistance information can be found through Novartis Gene Therapies. Visit Here →

Where can I find Zolgensma prescribing information?

Our team is still working to identify a prescribing information source for ZOLGENSMA

Where can I find Zolgensma side effect information?

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

Does billing ZOLGENSMA require JZ/JW wastage modifiers?

CMS does not include ZOLGENSMA (J3399) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J3399. 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.