CareCost Vials
4 × 350 mg
1 billing unit = 2 mg
1,400 mg dose → 700 billing units
J0175 · donanemab-azbt
350 mg/20 mL single-dose vial · JZ on every infusion
Calculate this patient's units ↓350 mg → 700 mg → 1,050 mg titration, then 1,400 mg every 4 weeks
This Kisunla claim carries straight into Claim Check.
Claim Check builds the whole visit — J0175 units, the administration line, the modifiers and the Medicare allowed amount — and prices it against your payer's rate. The estimate turns the same visit into what the patient owes.
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Patient owes, 1,400 mg
Change the payer and the estimate re-prices against that payer's own published rate. The result is a good faith estimate for the patient.
J0175 bills 1 unit per 2 mg: ordered dose ÷ 2 mg = billing units. A 350 mg dose is 175 units, a 700 mg dose is 350 units, and the 1,400 mg maintenance dose is 700 units. Kisunla's dose is not flat: it titrates over the first three infusions before settling at the maintenance dose.
Kisunla ships as a 350 mg/20 mL single-dose vial, so every step of the titration draws a whole number of vials with nothing left over: one vial for 350 mg, two for 700 mg, three for 1,050 mg, four for 1,400 mg. Because the draw always matches the dose exactly, JZ (no drug discarded) is the modifier on every Kisunla infusion, and JW never applies.
Medicare pays $4.185 per 2 mg (ASP+6%), effective for claims in Q4 2026 — $2,929.50
for the 700-unit maintenance dose above.
| Infusion | Dose | Billing units | Vials | Modifier |
|---|---|---|---|---|
| Infusion 1 | 350 mg | 175 | 1 × 350 mg | JZ |
| Infusion 2 | 700 mg | 350 | 2 × 350 mg | JZ |
| Infusion 3 | 1,050 mg | 525 | 3 × 350 mg | JZ |
| Infusion 4 and beyond (maintenance) | 1,400 mg | 700 | 4 × 350 mg | JZ |
Every step of the titration is a whole number of 350 mg vials, so JZ applies on all four infusions and JW never comes up on a Kisunla claim.
JZ — no discarded drug from a single-dose container. JW — discarded drug from a single-dose container, reported on its own claim line. One of the two is required on every J0175 claim per CMS's July 1, 2023 single-dose container policy.
J0175 × 175 JZ · 96365 × 1.
J0175 × 700 JZ · 96365 × 1. Every step of the titration works out the
same way — JZ is the modifier on every Kisunla infusion, and JW never applies.
96365 covers the initial hour of a therapeutic infusion. Kisunla's 30-minute infusion fits inside that window, so bill 96365 alone; the add-on code 96366 (each additional hour) does not apply. 96413 is the chemotherapy administration family; Kisunla is a non-oncology monoclonal antibody, so 96413 is the wrong code.
The MUE for J0175 is 700 units per day, exactly the 1,400 mg maintenance dose. A claim billed at the maintenance dose sits right at that limit; a claim line above 700 units for a single day fails the MUE edit, so the titration doses (175, 350 and 525 units) and the 700-unit maintenance dose all clear the edit, but nothing above 700 does.
Kisunla ships in one size: a 350 mg/20 mL (17.5 mg/mL) single-dose vial. J0175 (“Injection, donanemab-azbt, 2 mg”) is the HCPCS code for Kisunla. Leqembi (lecanemab-irmb, J0174) is the other anti-amyloid antibody approved for early Alzheimer's disease — a separate product with its own dosing and its own code, not interchangeable with Kisunla, and some payers require a patient to try one before the other. See the FDA Kisunla label (BLA 761248) for full dosing and administration instructions, or the current Medicare rate for J0175 →.
700 billing units. J0175 bills 1 unit per 2 mg, and 1,400 mg is the maintenance dose Kisunla reaches at infusion 4 and every 4 weeks after.
175 units for the 350 mg first infusion, 350 units for the 700 mg second infusion, and 525 units for the 1,050 mg third infusion, each a whole number of 350 mg vials billed with JZ.
JZ on every infusion. Each step of the titration (350, 700, 1,050 and 1,400 mg) is a whole multiple of the 350 mg single-dose vial, so nothing is ever discarded and JW does not apply.
700 units per day for J0175, exactly the 1,400 mg maintenance dose. A claim at the maintenance dose sits right at the limit; anything billed above it is denied.
Per 2 mg. J0175 is defined as 2 mg per billing unit, not 1 mg, so a 1,400 mg dose is 700 units, not 1,400.
Data current: pricing Q4 2026 · payer policies Aug 2026
Sources: CMS ASP pricing files (Q4 2026); FDA-approved prescribing information (KISUNLA label, DailyMed, BLA 761248); CMS single-dose container JW/JZ policy (effective July 1, 2023); CMS NCCI MUE table (practitioner services, 2026 Q3); CPT codebook administration-code guidance; 20 commercial payer medical policies in the donanemab Clearance corpus.
Reviewed September 20, 2026 by Erin Rose, CareCost Estimate founder. Methodology →