Acyclovir injection
Products billed under this code include Acyclovir Sodium.
Payment limit per 5 MG, by effective quarter, 1Q21 to 4Q26. Gaps mean the code was not in that quarter’s file, or CMS gave no payment limit.Products billed under J0133
From the 4Q26 NDC–HCPCS crosswalk. “Limit / pkg” is the 4Q26 payment limit times the billing units in one package.
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Acyclovir Sodium | Eugia US LLC | 55150-0154-10 | 1000 | $48.00 |
| Acyclovir Sodium | Eugia US LLC | 55150-0155-20 | 2000 | $96.00 |
| Acyclovir Sodium | FreseniUS Kabi USA, LLC | 63323-0325-10 | 1000 | $48.00 |
| Acyclovir Sodium | FreseniUS Kabi USA, LLC | 63323-0325-14 | 1000 | $48.00 |
| Acyclovir Sodium | FreseniUS Kabi USA, LLC | 63323-0325-20 | 2000 | $96.00 |
| Acyclovir Sodium | FreseniUS Kabi USA, LLC | 63323-0325-24 | 2000 | $96.00 |
| Acyclovir Sodium | FreseniUS Kabi USA, LLC | 65219-0622-10 | 1000 | $48.00 |
| Acyclovir Sodium | FreseniUS Kabi USA, LLC | 65219-0624-20 | 2000 | $96.00 |
| Acyclovir Sodium | Slate Run Pharmaceuticals | 70436-0030-82 | 1000 | $48.00 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $0.048 | +$0.013 | 5 MG | Acyclovir injection | v1, posted September 17, 2026 |
| 3Q26 | $0.035 | +$0.018 | 5 MG | Acyclovir injection | v1, posted September 15, 2026 |
| 2Q26 | $0.017 | −$0.102 | 5 MG | Acyclovir injection | v1, posted September 15, 2026 |
| 1Q26 | $0.119 | +$0.082 | 5 MG | Acyclovir injection | v1, posted September 15, 2026 |
| 4Q25 | $0.037 | +$0.008 | 5 MG | Acyclovir injection | v1, posted September 8, 2026 |
| 3Q25 | $0.029 | −$0.006 | 5 MG | Acyclovir injection | v1, posted March 10, 2026 |
| 2Q25 | $0.035 | −$0.016 | 5 MG | Acyclovir injection | v1, posted March 10, 2026 |
| 1Q25 | $0.051 | +$0.025 | 5 MG | Acyclovir injection | v1, posted December 19, 2025 |
| 4Q24 | $0.026 | −$0.013 | 5 MG | Acyclovir injection | v1, posted June 11, 2025 |
| 3Q24 | $0.039 | −$0.02 | 5 MG | Acyclovir injection | v1, posted June 11, 2025 |
| 2Q24 | $0.059 | +$0.003 | 5 MG | Acyclovir injection | v1, posted March 11, 2025 |
| 1Q24 | $0.056 | +$0.005 | 5 MG | Acyclovir injection | v1, posted December 19, 2024 |
| 4Q23 | $0.051 | +$0.004 | 5 MG | Acyclovir injection | v1, posted October 10, 2024 |
| 3Q23 | $0.047 | +$0.007 | 5 MG | Acyclovir injection | v1, posted June 5, 2024 |
| 2Q23 | $0.04 | −$0.01 | 5 MG | Acyclovir injection | v1, posted February 23, 2024 |
| 1Q23 | $0.05 | −$0.013 | 5 MG | Acyclovir injection | v1, posted December 6, 2023 |
| 4Q22 | $0.063 | +$0.042 | 5 MG | Acyclovir injection | v1, posted June 22, 2023 |
| 3Q22 | $0.021 | −$0.007 | 5 MG | Acyclovir injection | v1, posted June 9, 2023 |
| 2Q22 | $0.028 | −$0.013 | 5 MG | Acyclovir injection | v1, posted December 14, 2022 |
| 1Q22 | $0.041 | +$0.003 | 5 MG | Acyclovir injection | v1, posted June 8, 2022 |
| 4Q21 | $0.038 | −$0.002 | 5 MG | Acyclovir injection | v1, posted June 2, 2022 |
| 3Q21 | $0.04 | +$0.006 | 5 MG | Acyclovir injection | v1, posted June 2, 2022 |
| 2Q21 | $0.034 | −$0.008 | 5 MG | Acyclovir injection | v1, posted March 1, 2022 |
| 1Q21 | $0.042 | – | 5 MG | Acyclovir injection | v1, posted December 10, 2021 |
“Change” is the difference from the previous quarter, shown only when both quarters have a payment limit and the billing unit is the same. “vs. last quarter” and “vs. a year ago” follow the same rule.
CMS source files
- 4Q26: 2026-09-17_october-2026-medicare-part-b-payment-limit-files-final.zipposted September 17, 2026
- 4Q26: 2026-09-17_october-2026-ndc-hcpcs-crosswalk-final.zipposted September 17, 2026
- 3Q26: 2026-09-15_july-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 2Q26: 2026-09-15_april-2026-medicare-part-b-payment-limit-files-final-file.zipposted September 15, 2026
- 1Q26: 2026-09-15_january-2026-medicare-part-b-payment-limit-files.zipposted September 15, 2026
- 4Q25: 2026-09-08_october-2025-asp-pricing-final-file.zipposted September 8, 2026
- 3Q25: 2026-03-10_july-2025-asp-pricing-file.zipposted March 10, 2026
- 2Q25: 2026-03-10_april-2025-asp-pricing-file.zipposted March 10, 2026
- 1Q25: 2025-12-19_january-2025-asp-pricing-file-03-11-25-final-file.zipposted December 19, 2025
- 4Q24: 2025-06-11_october-2024-asp-pricing-file.zipposted June 11, 2025
- 3Q24: 2025-06-11_july-2024-asp-pricing-file.zipposted June 11, 2025
- 2Q24: 2025-03-11_april-2024-asp-pricing-file.zipposted March 11, 2025
- 1Q24: 2024-12-19_january-2024-asp-pricing-file.zipposted December 19, 2024
- 4Q23: 2024-10-10_october-2023-asp-pricing-file.zipposted October 10, 2024
- 3Q23: 2024-06-05_july-2023-asp-pricing-file.zipposted June 5, 2024
- 2Q23: 2024-02-23_april-2023-asp-pricing-file.zipposted February 23, 2024
- 1Q23: 2023-12-06_january-2023-asp-pricing-file.zipposted December 6, 2023
- 4Q22: 2023-06-22_october-2022-asp-pricing-file.zipposted June 22, 2023
- 3Q22: 2023-06-09_july-2022-asp-pricing-file.zipposted June 9, 2023
- 2Q22: 2022-12-14_april-2022-asp-pricing-file.zipposted December 14, 2022
- 1Q22: 2022-06-08_january-2022-asp-pricing-file.zipposted June 8, 2022
- 4Q21: 2022-06-02_october-2021-asp-pricing-file.zipposted June 2, 2022
- 3Q21: 2022-06-02_july-2021-asp-pricing-file.zipposted June 2, 2022
- 2Q21: 2022-03-01_april-2021-asp-pricing-file.zipposted March 1, 2022
- 1Q21: 2021-12-10_january-2021-asp-pricing-file.zipposted December 10, 2021