EXPAREL is reimbursed for procedures performed in ASCs using the code C9290 and for dental procedures using code D9613.*
C9290: For procedures performed in ASCs
Effective January 1, 2019, the Centers for Medicare and Medicaid (CMS) Services reinstated a unique, product-specific
billing code, or a HCPCS code C9290, and Revenue code 0636 for EXPAREL in ASC. To learn more, click here.
Effective July 1, 2021
EXPAREL is reimbursed at $1.33/mg*
Allowed amount for reimbursement:
$353.78† 266 mg (20 mL) dose
$176.89† 133 mg (10 mL) dose
D9613: For dental procedures
D9613 is defined as the infiltration of a sustained-release therapeutic drug (single or multiple sites), which allows for EXPAREL reimbursement in oral surgery procedures.
For more information, contact our dedicated reimbursement specialists at reimbursement@pacira.com or call our Reimbursement Helpline at 1-855-793-9727.
Pricing is subject to CMS updates.
ASC, ambulatory surgery center; CMS, Centers for Medicare and Medicaid Services; HCPCS, healthcare common procedure coding system.
*Pricing is subject to Centers for Medicare & Medicaid Services (CMS) Medicare updates.
†The allowed amount for reimbursement is based on the full dose being used for the surgical procedure.