`J0744` Ciprofloxacin iv

Injection, ciprofloxacin for intravenous infusion, 200 mg

Medicare coverage: Carrier judgment
Status: active (October 2026 file)

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 6 units per day (clinical), rationale: Prescribing Information
Outpatient hospital: max 8 units per day (clinical), rationale: Prescribing Information
DME supplier: max 0 units per day (clinical), rationale: CMS Policy

Medicare pricing for J0744

Medicare Part B drug payment limit (ASP, October 2026)

J0744 payment limit: $1.93 per 200 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.

NDCs that bill under J0744 (CMS ASP NDC-HCPCS crosswalk, October 2026)

00409-2300-24 Ciprofloxacin, Pfizer Inc: 24 billing units per package (24 POUCH in 1 CARTON / 1 BAG in 1 POUCH / 100 mL in 1 BAG)
00409-3300-24 Ciprofloxacin, Pfizer Inc: 48 billing units per package (24 POUCH in 1 CARTON / 1 BAG in 1 POUCH / 200 mL in 1 BAG)
25021-0114-82 Ciprofloxacin, Sagent Pharmaceuticals: 24 billing units per package (24 POUCH in 1 CARTON / 1 BAG in 1 POUCH / 100 mL in 1 BAG)
25021-0114-87 Ciprofloxacin, Sagent Pharmaceuticals: 48 billing units per package (24 POUCH in 1 CARTON / 1 BAG in 1 POUCH / 200 mL in 1 BAG)
25021-0192-82 Ciprofloxacin, Sagent Pharmaceuticals: 24 billing units per package (24 POUCH in 1 CARTON / 1 BAG in 1 POUCH / 100 mL in 1 BAG)
25021-0192-87 Ciprofloxacin, Sagent Pharmaceuticals: 48 billing units per package (24 POUCH in 1 CARTON / 1 BAG in 1 POUCH / 200 mL in 1 BAG)

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for J0744

Payer coverage policies that name J0744

J0744 appears in 4 coverage policies from Aetna, Anthem.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Anthrax (0483) Obiltoxaximab (Anthim), Raxibacumab	covered if criteria are met	Jul 29, 2026	payer document
Aetna	Hyperbaric Oxygen Therapy (HBOT) (0172)	listed, no stance	Apr 21, 2026	payer document
Aetna	Injectable Medications (0020)	listed, no stance (range J0278-J2543)	Mar 5, 2026	payer document
Anthem	Parenteral Antibiotics for the Treatment of Lyme Disease (CG-MED-98)	not covered	Nov 6, 2025	payer document

Medicaid fee-for-service

AZ: $1.72 (outpatient_hospital), effective Jul 1, 2026
FL: $6.00 (physician_administered_drugs), effective Jan 1, 2026
IL: $0.73 (practitioner), effective Apr 1, 2026
IN: $1.03 (professional, Advanced Practice Nurse (85%), non-facility), effective Oct 1, 2021
KS: $1.93 (default), effective Oct 1, 2026
KY: $0.00 (asc), effective Jan 1, 2026
LA: $1.72 (professional), effective Jul 1, 2026
NE: $1.72 (injectables), effective Jul 1, 2026
OH: $1.72 (provider_administered_drugs), effective Jul 1, 2026
OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026
TX: $2.00 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, non-facility), effective Sep 1, 2026
VA: $1.72 (medical), effective Jul 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $1.72 (professional_administered_drugs), effective Jul 1, 2026
WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

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.

J0744 Ciprofloxacin iv