HCPCS J0696: Ceftriaxone Sodium Injection
HCPCS J0696 reports injectable ceftriaxone sodium, per 250 mg — a broad-spectrum cephalosporin antibiotic. As a Part B drug it is paid at approximately ASP plus 6%, billed per unit with the NDC. Report drug waste from single-dose vials with the JW modifier and no-waste with JZ.
- Code type
- HCPCS Level II drug (per 250 mg)
- Priced under
- Part B: ~ASP + 6%
- Billed per
- Per 250 mg unit, with the NDC
- Waste modifier
- JW (discarded) / JZ (no waste)
What is HCPCS J0696 used for?
HCPCS J0696 reports injectable ceftriaxone sodium, per 250 mg — a broad-spectrum third-generation cephalosporin antibiotic (brand Rocephin) given IM or IV for a wide range of bacterial infections. J0696 bills the drug; the injection administration (96372) or the appropriate infusion code is billed separately.
How do you count units for J0696?
The descriptor is per 250 mg, so units follow the dose:
| Dose given | Units of J0696 |
|---|---|
| 250 mg | 1 |
| 500 mg | 2 |
| 1,000 mg (1 g) | 4 |
Example: a 1 gram IM ceftriaxone dose is billed as J0696 x4 units plus 96372 for the administration, with the NDC on the drug line.
How is J0696 priced, and why the NDC?
As a Medicare Part B separately payable drug, ceftriaxone is reimbursed at roughly ASP plus 6 percent. The average sales price is published by CMS and updated quarterly, so the exact dollar amount changes each quarter — this card describes the methodology, not a fixed rate. The NDC is required on the claim to identify the specific product, vial size, and manufacturer for correct pricing.
How do JW and JZ modifiers apply to J0696?
- JW — reports the discarded amount from a single-dose vial on a separate line.
- JZ — attests there was no discarded amount.
One of the two is required on separately payable single-dose-container drugs so Medicare can pay for the labeled amount and track waste. The same ASP-and-waste rules govern the sibling drugs J1885, J3301, and J1100. Confirm payable administration rates in the Medicare fee calculator under Part B.
Frequently asked questions
J0696 is per 250 mg. A 1 gram (1,000 mg) IM or IV dose is 4 units; a 500 mg dose is 2 units; a 250 mg dose is 1 unit. Convert milligrams to 250 mg increments and report that count, with the product NDC on the line.
As a Medicare Part B separately payable drug, ceftriaxone is reimbursed at approximately ASP plus 6 percent. CMS updates the average sales price quarterly, so the dollar rate changes every quarter. Bill per unit and let the payer apply the current ASP-based amount.
For single-dose vials, append JW to a separate line for the discarded amount, or JZ to attest no waste. One is required on separately payable single-dose-container drugs. Reconstituted single-dose vials still follow the discarded-drug reporting rules.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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