Injection, cefazolin sodium (wg critical care), not therapeutically equivalent to j0690, 500 mg
Medicare coverage: Special coverage instructions apply
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 16 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 16 units per day (clinical), rationale: CMS Policy
DME supplier: max 16 units per day (clinical), rationale: CMS Policy
Medicare pricing for J0687
Medicare Part B drug payment limit (ASP, October 2026)
J0687 payment limit: $0.663 per 500 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.
NDCs that bill under J0687 (CMS ASP NDC-HCPCS crosswalk, October 2026)
44567-0840-25 Cefazolin Sodium, WG Critical Care, LLC: 100 billing units per package (25 VIAL in 1 CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL)
44567-0845-25 Cefazolin Sodium, WG Critical Care, LLC: 150 billing units per package (25 VIAL in 1 CARTON / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL)
Physician Fee Schedule (CY 2026, RVU26D)
Status E: excluded from the PFS by regulation.
Payer policies and prior authorization for J0687
Payer coverage policies that name J0687
J0687 appears in 2 coverage policies from Aetna, Anthem.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.