HCPCS Level II drug code
J0295 — Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm
In short
J0295 is the HCPCS Level II code for injection, ampicillin sodium/sulbactam sodium, per 1.5 gm. CMS assigns NDCs for Ampicillin-Sulbactam and Unasyn to it. The Medicare Part B payment limit is $1.457 per unit (October 1, 2026 through December 31, 2026).
Code
CMS HCPCS fileHCPCS codeJ0295
Billing unitSee descriptor
- Descriptor
- Injection, ampicillin sodium/sulbactam sodium, per 1.5 gm
- Short descriptor
- Ampicillin sulbactam 1.5 gm
- Code set
- HCPCS Level II, maintained by CMS
- Effective
- Jan 1, 2019
Medicare Part B payment limit
CMS ASP filePayment limit per unit$1.457
Per1.5 gm
Coinsurance20%
Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Units and claim line
Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.
Enter the units to build the claim line.
NDCs billed under J0295
CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 44 NDCs to J0295 for Ampicillin-Sulbactam and Unasyn. Billing units per package are CMS’s figures for this code’s unit.
| Drug | NDC (11-digit) | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| Ampicillin-Sulbactam | 00409-2689-01 | Pfizer Inc | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 00409-2987-03 | Pfizer Inc | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 00641-6116-10 | Hikma Pharmaceuticals USA Inc. | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 00641-6117-10 | Hikma Pharmaceuticals USA Inc. | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 00641-6118-01 | Hikma Pharmaceuticals USA Inc. | 1 | 10 |
| Ampicillin-Sulbactam | 25021-0142-20 | Sagent Pharmaceuticals | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 25021-0143-30 | Sagent Pharmaceuticals | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 25021-0144-99 | Sagent Pharmaceuticals | 30 | 10 |
| Ampicillin-Sulbactam | 25021-0188-99 | Sagent Pharmaceuticals | 1 | 10 |
| Ampicillin-Sulbactam | 44567-0150-10 | WG Critical Care, LLC | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 44567-0210-10 | WG Critical Care, LLC | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 44567-0211-10 | WG Critical Care, LLC | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 44567-0212-01 | WG Critical Care, LLC | 1 | 10 |
| Ampicillin-Sulbactam | 55150-0116-10 | Eugia US LLC | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 55150-0116-20 | Eugia US LLC | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 55150-0117-10 | Eugia US LLC | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 55150-0117-20 | Eugia US LLC | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 55150-0118-01 | Eugia US LLC | 1 | 10 |
| Ampicillin-Sulbactam | 55150-0118-99 | Eugia US LLC | 1 | 10 |
| Ampicillin-Sulbactam | 66794-0206-41 | Piramal Critical Care Inc | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 66794-0208-15 | Piramal Critical Care Inc | 1 | 10 |
| Ampicillin-Sulbactam | 71288-0005-20 | Meitheal Pharmaceuticals Inc. | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 71288-0006-30 | Meitheal Pharmaceuticals Inc. | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 71288-0007-75 | Meitheal Pharmaceuticals Inc. | 1 | 10 |
| Ampicillin-Sulbactam | 71288-0031-21 | Meitheal Pharmaceuticals Inc. | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 71288-0031-92 | Meitheal Pharmaceuticals Inc. | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 71288-0032-21 | Meitheal Pharmaceuticals Inc. | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 71288-0032-92 | Meitheal Pharmaceuticals Inc. | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 71288-0033-75 | Meitheal Pharmaceuticals Inc. | 1 | 10 |
| Ampicillin-Sulbactam | 71288-0033-91 | Meitheal Pharmaceuticals Inc. | 1 | 10 |
| Ampicillin-Sulbactam | 72485-0416-10 | Armas Pharmaceuticals Inc. | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 72485-0417-10 | Armas Pharmaceuticals Inc. | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 72485-0418-15 | Armas Pharmaceuticals Inc. | 1 | 10 |
| Ampicillin-Sulbactam | 72572-0021-10 | Civica, Inc. | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 72572-0022-10 | Civica, Inc. | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 72572-0136-10 | Civica, Inc. | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 72603-0220-10 | Northstar RxLLC | 10 × 1 | 10 |
| Ampicillin-Sulbactam | 72603-0335-10 | Northstar RxLLC | 10 × 1 | 20 |
| Ampicillin-Sulbactam | 72603-0444-01 | Northstar RxLLC | 10 × 1 | 100 |
| Ampicillin-Sulbactam | 83634-0108-99 | Avenacy Inc. | 1 | 10 |
| Ampicillin-Sulbactam | 83634-0110-20 | Avenacy Inc. | 10 × 1 | 20 |
| Unasyn | 00049-0013-83 | Pfizer Inc | 10 × 1 | 10 |
| Unasyn | 00049-0014-83 | Pfizer Inc | 10 × 1 | 20 |
| Unasyn | 00049-0024-28 | Pfizer Inc | 1 | 10 |
J0295: common questions
- Is J0295 a CPT code?
- No. J0295 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
- What NDCs are billed under J0295?
- CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 44 NDCs under J0295, for Ampicillin-Sulbactam and Unasyn. The table on this page shows each one with its billing units per package.
- What is the Medicare payment limit for J0295?
- $1.457 per 1.5 gm, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.