`J2795` Ropivacaine hcl injection

Injection, ropivacaine hydrochloride, 1 mg

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

Medically Unlikely Edits (effective October 1, 2026)

Practitioner: max 200 units per day (clinical), rationale: Prescribing Information
Outpatient hospital: max 2400 units per day (clinical), rationale: Clinical: Data
DME supplier: max 0 units per day (clinical), rationale: CMS Policy

Medicare pricing for J2795

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

J2795 payment limit: $0.04 per 1 MG, effective October 1, 2026 through December 31, 2026, based on 2Q26 ASP data. Coinsurance 20%.

NDCs that bill under J2795 (CMS ASP NDC-HCPCS crosswalk, October 2026)

63323-0285-10 Naropin, FreseniUS Kabi USA, LLC: 100 billing units per package (5 AMPULE in 1 BOX / 10 mL in 1 AMPULE)
63323-0285-13 Naropin, FreseniUS Kabi USA, LLC: 500 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 10 mL in 1 VIAL, SINGLE-DOSE)
63323-0285-20 Naropin, FreseniUS Kabi USA, LLC: 200 billing units per package (5 AMPULE in 1 BOX / 20 mL in 1 AMPULE)
63323-0285-23 Naropin, FreseniUS Kabi USA, LLC: 1000 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE)
63323-0285-28 Naropin, FreseniUS Kabi USA, LLC: 1000 billing units per package (25 VIAL, SINGLE-USE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-USE)
63323-0285-61 Naropin, FreseniUS Kabi USA, LLC: 4800 billing units per package (24 BAG in 1 CASE / 100 mL in 1 BAG)
63323-0285-63 Naropin, FreseniUS Kabi USA, LLC: 9600 billing units per package (24 BAG in 1 CASE / 200 mL in 1 BAG)
63323-0285-64 Naropin, FreseniUS Kabi USA, LLC: 4800 billing units per package (12 BOTTLE in 1 CASE / 200 mL in 1 BOTTLE)
63323-0285-65 Naropin, FreseniUS Kabi USA, LLC: 2400 billing units per package (12 BOTTLE in 1 CASE / 100 mL in 1 BOTTLE)
63323-0285-67 Naropin, FreseniUS Kabi USA, LLC: 2400 billing units per package (12 BOTTLE in 1 CASE / 100 mL in 1 BOTTLE)
63323-0285-68 Naropin, FreseniUS Kabi USA, LLC: 2400 billing units per package (12 BOTTLE in 1 CASE / 100 mL in 1 BOTTLE)
63323-0285-73 Naropin, FreseniUS Kabi USA, LLC: 4800 billing units per package (12 BOTTLE in 1 CASE / 200 mL in 1 BOTTLE)
63323-0286-00 Naropin, FreseniUS Kabi USA, LLC: 6000 billing units per package (12 BOTTLE in 1 CASE / 100 mL in 1 BOTTLE)
63323-0286-20 Naropin, FreseniUS Kabi USA, LLC: 500 billing units per package (5 AMPULE in 1 BOX / 20 mL in 1 AMPULE)
63323-0286-23 Naropin, FreseniUS Kabi USA, LLC: 2500 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE)
63323-0286-27 Naropin, FreseniUS Kabi USA, LLC: 2500 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE)
63323-0286-35 Naropin, FreseniUS Kabi USA, LLC: 3750 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 30 mL in 1 VIAL, SINGLE-DOSE)
63323-0286-38 Naropin, FreseniUS Kabi USA, LLC: 3750 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 30 mL in 1 VIAL, SINGLE-DOSE)
63323-0286-63 Naropin, FreseniUS Kabi USA, LLC: 12000 billing units per package (12 BOTTLE in 1 CASE / 200 mL in 1 BOTTLE)
63323-0286-95 Naropin, FreseniUS Kabi USA, LLC: 3750 billing units per package (25 VIAL, SINGLE-DOSE in 1 TRAY / 30 mL in 1 VIAL, SINGLE-DOSE)
63323-0287-20 Naropin, FreseniUS Kabi USA, LLC: 750 billing units per package (5 AMPULE in 1 BOX / 20 mL in 1 AMPULE)
63323-0287-21 Naropin, FreseniUS Kabi USA, LLC: 3750 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE)
63323-0288-10 Naropin, FreseniUS Kabi USA, LLC: 500 billing units per package (5 AMPULE in 1 BOX / 10 mL in 1 AMPULE)
63323-0288-11 Naropin, FreseniUS Kabi USA, LLC: 2500 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 10 mL in 1 VIAL, SINGLE-DOSE)
63323-0288-20 Naropin, FreseniUS Kabi USA, LLC: 1000 billing units per package (5 AMPULE in 1 BOX / 20 mL in 1 AMPULE)
63323-0288-21 Naropin, FreseniUS Kabi USA, LLC: 5000 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE)
63323-0288-27 Naropin, FreseniUS Kabi USA, LLC: 1000 billing units per package (5 AMPULE in 1 BOX / 20 mL in 1 AMPULE)
63323-0288-29 Naropin, FreseniUS Kabi USA, LLC: 5000 billing units per package (25 VIAL, SINGLE-DOSE in 1 TRAY / 20 mL in 1 VIAL, SINGLE-DOSE)
00404-9924-30 Naropin, Henry Schein Inc.: 150 billing units per package (1 VIAL, SINGLE-DOSE in 1 BAG / 30 mL in 1 VIAL, SINGLE-DOSE)
43066-0015-10 Ropivacaine, Baxter Healthcare Corporation: 400 billing units per package (10 VIAL in 1 CARTON / 20 mL in 1 VIAL)
43066-0019-10 Ropivacaine, Baxter Healthcare Corporation: 1000 billing units per package (10 VIAL in 1 CARTON / 20 mL in 1 VIAL)
43066-0023-10 Ropivacaine, Baxter Healthcare Corporation: 1500 billing units per package (10 VIAL in 1 CARTON / 30 mL in 1 VIAL)
43066-0027-10 Ropivacaine, Baxter Healthcare Corporation: 2000 billing units per package (10 VIAL in 1 CARTON / 20 mL in 1 VIAL)
43066-0152-10 Ropivacaine, Baxter Healthcare Corporation: 2000 billing units per package (10 BAG in 1 CARTON / 100 mL in 1 BAG)
43066-0154-10 Ropivacaine, Baxter Healthcare Corporation: 4000 billing units per package (10 BAG in 1 CARTON / 200 mL in 1 BAG)
55150-0195-20 Ropivacaine, Eugia US LLC: 1000 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE)
55150-0196-99 Ropivacaine, Eugia US LLC: 200 billing units per package (1 BOTTLE, GLASS in 1 CARTON / 100 mL in 1 BOTTLE, GLASS)
55150-0197-20 Ropivacaine, Eugia US LLC: 2500 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE)
55150-0198-30 Ropivacaine, Eugia US LLC: 3750 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 30 mL in 1 VIAL, SINGLE-DOSE)
55150-0199-20 Ropivacaine, Eugia US LLC: 3750 billing units per package (25 VIAL, SINGLE-DOSE in 1 CARTON / 20 mL in 1 VIAL, SINGLE-DOSE)

And 58 more NDCs.

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for J2795

Payer coverage policies that name J2795

J2795 appears in 5 coverage policies from Aetna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Anesthetic and Antiemetic Infusion Pumps (0607)	listed, no stance	Sep 9, 2026	payer document
Aetna	Eagle's and Ernest Syndrome (0400)	listed, no stance	Jun 30, 2026	payer document
Aetna	Injectable Medications (0020)	listed, no stance (range J2550-J3520)	Mar 5, 2026	payer document
Aetna	Vasectomy Procedures and Chronic Scrotal Content Pain (0027)	listed, no stance	Jan 27, 2026	payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)	Sphenopalatine Ganglion Block for Headache	listed, no stance	Aug 15, 2025	payer document

Medicaid fee-for-service

AZ: $0.04 (outpatient_hospital), effective Jul 1, 2026
IL: $0.05 (practitioner), effective Apr 1, 2026
IN: $0.03 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2016
KY: $0.00 (asc), effective Jan 1, 2026
MS: $0.05 (comprehensive), effective Jul 1, 2026
NE: $0.03 (injectables), effective Jul 1, 2026
OH: $0.05 (provider_administered_drugs), effective Jul 1, 2026
OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026
TX: $0.05 (healthy_texas_women, Clinic/Group Practice, non-facility), effective Sep 1, 2026
VA: $0.03 (medical), effective Jul 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
WA: $0.04 (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.

J2795 Ropivacaine hcl injection