CareCost Syringes
1 × 60 mg
1 billing unit = 1 mg
60 mg dose → 60 billing units
J0897 · denosumab
60 mg/mL single-use prefilled syringe · JZ on nearly every claim
Calculate this patient's units ↓60 mg subcutaneously once every 6 months · the same dose for every labeled indication
Your Prolia dose and 60 billing units carry straight into the estimate.
Pick the payer, enter what the patient has already met toward the deductible and the out-of-pocket maximum, and choose a copay program. CareCost returns the patient's share as a good faith estimate you can hand over.
Patient owes, 60 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.
37 payer price files · Commercial + Medicare · Copay and foundation status · Deductible, coinsurance and out-of-pocket math
Prolia J0897 is billed in units of 1 mg: ordered dose ÷ 1 mg = billing units. The labeled dose is a flat 60 mg for every indication, regardless of weight or age, so the calculation has no per-kilogram multiplication and nothing to round -- 60 mg ÷ 1 mg = 60 billing units, every time.
Prolia ships as a 60 mg/mL single-use prefilled syringe sized to match the labeled dose exactly, so the amount drawn (60 mg) equals the amount administered (60 mg) with nothing left over. That is why JZ (no drug discarded) is the modifier on virtually every Prolia claim -- unlike a multi-dose-vial drug, there is no per-vial waste math to do.
Medicare pays $30.101 per mg (ASP+6%), effective for claims in Q3 2026 — $1,806.06
for the 60-unit dose above.
| Product | HCPCS | Dose | Billing units |
|---|---|---|---|
| Prolia (reference product) | J0897 | 60 mg | 60 |
| Xgeva (different product, same code) | J0897 | 120 mg | 120 |
| Jubbonti (denosumab-bbdz, biosimilar) | Q5136 | 60 mg | 60 |
| Stoboclo (denosumab-bmwo, biosimilar) | Q5157 | 60 mg | 60 |
| Conexxence (denosumab-bnht, biosimilar) | Q5158 | 60 mg | 60 |
| Enoby (denosumab-qbde, biosimilar) | Q5167 | 60 mg | 60 |
Prolia and Xgeva are both denosumab and both bill J0897 -- only the unit count on the claim (60 vs. 120) shows which product was actually given. Each biosimilar HCPCS code above also covers a second, 120 mg Xgeva-equivalent trade name from the same maker (Q5136 = Jubbonti/Wyost, Q5157 = Stoboclo/Osenvelt, Q5158 = Conexxence/Bomyntra, Q5167 = Enoby/Xtrenbo) that bills 120 units instead of 60 -- the rows above are the 60 mg, Prolia-equivalent half of each code only.
JZ — no discarded drug from the single-dose prefilled syringe. JW — discarded drug, reported on its own claim line. One of the two is required on every J0897 claim per CMS's July 1, 2023 single-dose container policy.
J0897 × 60 JZ · 96372 × 1. This is the case on virtually every Prolia
claim, because the prefilled syringe is sized to match the labeled dose exactly.
J0897 × 45 · J0897 × 15 JW · 96372 × 1. Prolia's labeling
does not call for partial dosing; this is shown only to illustrate the modifier math.
96372 covers a therapeutic, prophylactic, or diagnostic injection given subcutaneously or intramuscularly. Prolia's subcutaneous injection is billed with 96372 alone -- there is no infusion time to report, so the infusion-administration codes (96413 initial hour, 96415 each additional hour) used by IV biologics do not apply. Prolia is also not a chemotherapeutic agent, so the chemo-injection code 96401 does not apply either. The visit itself typically runs about 15 minutes, including a brief observation period after the injection.
Prolia is supplied as a 60 mg/mL single-use prefilled syringe — there is no other size and no vial to reconstitute. Lead NDC 55513-730-01 (Amgen, labeler 55513). See the FDA Prolia label (BLA 125320) for full dosing and administration instructions.
J0897 is the reference-product code for Prolia, and it is shared with Xgeva — the same molecule at a 120 mg oncology dose. Four biosimilar Q-codes cover the rest of the denosumab family — Q5136, Q5157, Q5158 and Q5167 — each billed under its own HCPCS rather than J0897. CMS has not published a payment rate for Q5167 (Enoby) in any quarter to date. See the HCPCS hub for coding across the full family. The Medicare rate for every quarter is on the cost page →
60 billing units. Prolia J0897 bills 1 unit per 1 mg, so a 60 mg dose is always 60 units.
J0897. Xgeva, a different denosumab product dosed at 120 mg for cancer-related bone loss, bills under the same code — only the unit count (60 vs. 120) tells the two products apart on a claim.
JZ on virtually every claim. The 60 mg dose exactly fills the single-dose 60 mg prefilled syringe, so nothing is left over to discard. JW only applies on the rare claim where less than the full syringe is administered.
No. Prolia is a subcutaneous injection billed with 96372, not an infusion
administration code — there is no infusion time, initial hour, or additional hour to report.
The IV infusion codes 96413 and 96415 do not apply at any dose, and neither
does the chemotherapy injection code 96401: denosumab for osteoporosis is not a
chemotherapeutic agent.
Billing an infusion administration code (96413 or 96415) instead of the injection code 96372, or confusing Prolia's 60 mg dose with Xgeva's 120 mg dose since both share J0897.
60 mg once every 6 months — 2 doses a year — the same schedule for every labeled indication.
$30.101 per mg (ASP+6%), effective for claims in Q3 2026 — $1,806.06 for the standard 60 mg dose.
Data current: pricing Q3 2026 · payer policies Aug 2026
Sources: CMS ASP pricing files (Q3 2026); Medicare physician fee schedule (96372, national non-facility); FDA-approved prescribing information (Prolia label, Amgen, BLA 125320); CMS single-dose container JW/JZ policy (effective July 1, 2023); CPT codebook administration-code guidance; 27 of 30 commercial payer medical policies verified against the CareCost Clearance coverage corpus.
Reviewed September 11, 2026 by Erin Rose, CareCost Estimate founder. Methodology →