Ampicillin sulbactam 1.5 gm
Products billed under this code include Ampicillin-Sulbactam, Unasyn.
Payment limit per 1.5 GM, 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 J0295
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 |
|---|---|---|---|---|
| Ampicillin-Sulbactam | Pfizer Inc | 00409-2689-01 | 10 | $14.57 |
| Ampicillin-Sulbactam | Pfizer Inc | 00409-2987-03 | 20 | $29.14 |
| Ampicillin-Sulbactam | Hikma Pharmaceuticals USA Inc. | 00641-6116-10 | 10 | $14.57 |
| Ampicillin-Sulbactam | Hikma Pharmaceuticals USA Inc. | 00641-6117-10 | 20 | $29.14 |
| Ampicillin-Sulbactam | Hikma Pharmaceuticals USA Inc. | 00641-6118-01 | 10 | $14.57 |
| Ampicillin-Sulbactam | Sagent Pharmaceuticals | 25021-0142-20 | 10 | $14.57 |
| Ampicillin-Sulbactam | Sagent Pharmaceuticals | 25021-0143-30 | 20 | $29.14 |
| Ampicillin-Sulbactam | Sagent Pharmaceuticals | 25021-0144-99 | 10 | $14.57 |
| Ampicillin-Sulbactam | Sagent Pharmaceuticals | 25021-0188-99 | 10 | $14.57 |
| Ampicillin-Sulbactam | WG Critical Care, LLC | 44567-0150-10 | 20 | $29.14 |
Show all 44 products
| Product | Labeler | NDC | Units / pkg | Limit / pkg |
|---|---|---|---|---|
| Ampicillin-Sulbactam | WG Critical Care, LLC | 44567-0210-10 | 10 | $14.57 |
| Ampicillin-Sulbactam | WG Critical Care, LLC | 44567-0211-10 | 20 | $29.14 |
| Ampicillin-Sulbactam | WG Critical Care, LLC | 44567-0212-01 | 10 | $14.57 |
| Ampicillin-Sulbactam | Eugia US LLC | 55150-0116-10 | 10 | $14.57 |
| Ampicillin-Sulbactam | Eugia US LLC | 55150-0116-20 | 10 | $14.57 |
| Ampicillin-Sulbactam | Eugia US LLC | 55150-0117-10 | 20 | $29.14 |
| Ampicillin-Sulbactam | Eugia US LLC | 55150-0117-20 | 20 | $29.14 |
| Ampicillin-Sulbactam | Eugia US LLC | 55150-0118-01 | 10 | $14.57 |
| Ampicillin-Sulbactam | Eugia US LLC | 55150-0118-99 | 10 | $14.57 |
| Ampicillin-Sulbactam | Piramal Critical Care Inc | 66794-0206-41 | 10 | $14.57 |
| Ampicillin-Sulbactam | Piramal Critical Care Inc | 66794-0208-15 | 10 | $14.57 |
| Ampicillin-Sulbactam | Meitheal Pharmaceuticals Inc. | 71288-0005-20 | 10 | $14.57 |
| Ampicillin-Sulbactam | Meitheal Pharmaceuticals Inc. | 71288-0006-30 | 20 | $29.14 |
| Ampicillin-Sulbactam | Meitheal Pharmaceuticals Inc. | 71288-0007-75 | 10 | $14.57 |
| Ampicillin-Sulbactam | Meitheal Pharmaceuticals Inc. | 71288-0031-21 | 10 | $14.57 |
| Ampicillin-Sulbactam | Meitheal Pharmaceuticals Inc. | 71288-0031-92 | 10 | $14.57 |
| Ampicillin-Sulbactam | Meitheal Pharmaceuticals Inc. | 71288-0032-21 | 20 | $29.14 |
| Ampicillin-Sulbactam | Meitheal Pharmaceuticals Inc. | 71288-0032-92 | 20 | $29.14 |
| Ampicillin-Sulbactam | Meitheal Pharmaceuticals Inc. | 71288-0033-75 | 10 | $14.57 |
| Ampicillin-Sulbactam | Meitheal Pharmaceuticals Inc. | 71288-0033-91 | 10 | $14.57 |
| Ampicillin-Sulbactam | Armas Pharmaceuticals Inc. | 72485-0416-10 | 10 | $14.57 |
| Ampicillin-Sulbactam | Armas Pharmaceuticals Inc. | 72485-0417-10 | 20 | $29.14 |
| Ampicillin-Sulbactam | Armas Pharmaceuticals Inc. | 72485-0418-15 | 10 | $14.57 |
| Ampicillin-Sulbactam | Civica, Inc. | 72572-0021-10 | 10 | $14.57 |
| Ampicillin-Sulbactam | Civica, Inc. | 72572-0022-10 | 20 | $29.14 |
| Ampicillin-Sulbactam | Civica, Inc. | 72572-0136-10 | 20 | $29.14 |
| Ampicillin-Sulbactam | Northstar RxLLC | 72603-0220-10 | 10 | $14.57 |
| Ampicillin-Sulbactam | Northstar RxLLC | 72603-0335-10 | 20 | $29.14 |
| Ampicillin-Sulbactam | Northstar RxLLC | 72603-0444-01 | 100 | $145.70 |
| Ampicillin-Sulbactam | Avenacy Inc. | 83634-0108-99 | 10 | $14.57 |
| Ampicillin-Sulbactam | Avenacy Inc. | 83634-0110-20 | 20 | $29.14 |
| Unasyn | Pfizer Inc | 00049-0013-83 | 10 | $14.57 |
| Unasyn | Pfizer Inc | 00049-0014-83 | 20 | $29.14 |
| Unasyn | Pfizer Inc | 00049-0024-28 | 10 | $14.57 |
Every quarter
| Quarter | Payment limit | Change | Billing unit | Description | Source file |
|---|---|---|---|---|---|
| 4Q26 | $1.457 | +$0.006 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted September 17, 2026 |
| 3Q26 | $1.451 | +$0.099 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted September 15, 2026 |
| 2Q26 | $1.352 | +$0.023 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted September 15, 2026 |
| 1Q26 | $1.329 | −$0.063 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted September 15, 2026 |
| 4Q25 | $1.392 | −$0.102 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted September 8, 2026 |
| 3Q25 | $1.494 | −$0.079 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted March 10, 2026 |
| 2Q25 | $1.573 | −$0.068 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted March 10, 2026 |
| 1Q25 | $1.641 | −$0.376 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted December 19, 2025 |
| 4Q24 | $2.017 | +$0.077 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted June 11, 2025 |
| 3Q24 | $1.94 | −$0.183 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted June 11, 2025 |
| 2Q24 | $2.123 | +$0.354 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted March 11, 2025 |
| 1Q24 | $1.769 | −$0.279 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted December 19, 2024 |
| 4Q23 | $2.048 | +$0.158 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted October 10, 2024 |
| 3Q23 | $1.89 | −$0.278 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted June 5, 2024 |
| 2Q23 | $2.168 | −$0.114 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted February 23, 2024 |
| 1Q23 | $2.282 | −$0.35 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted December 6, 2023 |
| 4Q22 | $2.632 | +$0.394 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted June 22, 2023 |
| 3Q22 | $2.238 | −$0.175 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted June 9, 2023 |
| 2Q22 | $2.413 | −$0.314 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted December 14, 2022 |
| 1Q22 | $2.727 | +$0.518 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted June 8, 2022 |
| 4Q21 | $2.209 | −$0.579 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted June 2, 2022 |
| 3Q21 | $2.788 | +$0.035 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted June 2, 2022 |
| 2Q21 | $2.753 | +$0.292 | 1.5 GM | Ampicillin sulbactam 1.5 gm | v1, posted March 1, 2022 |
| 1Q21 | $2.461 | – | 1.5 GM | Ampicillin sulbactam 1.5 gm | 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