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Effective January 1, 2025: ASP+6% reimbursement for EXPAREL when billing with code J0666 across all outpatient surgical settings.

Read below for the latest updates regarding EXPAREL and the latest pricing and reimbursement information that may be important for your site(s) of care

Recent Clinical Data

EXPAREL is the only FDA-approved single dose regional analgesic to safely demonstrate four days of superiority versus bupivacaine in two clinical studies. New indications for use as an adductor canal block and sciatic nerve block in the popliteal fossa will significantly extend reach within more than 3 million lower extremity procedures.

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340B Pricing

340B pricing available for EXPAREL as of October 2022.

Now on selected GPO contracts

Connect with us for more specific information about GPO Contracts.

We currently have GPO contracts with the following partners:

  • Sevāredent
  • Premier

NOPAIN Act

Reimbursement for EXPAREL in the hospital outpatient department beginning January 1, 2025

  • The NOPAIN Act is a federal mandate that requires Medicare to reimburse for non-opioids, like EXPAREL® (bupivacaine liposome injectable suspension), used during all surgeries conducted in the hospital outpatient department (HOPD) setting. This will expand Medicare reimbursement beyond the ambulatory surgery center (ASC), which is currently available for EXPAREL using code C9290.

Reimbursement in the ASC for Medicare Patients

EXPAREL is reimbursed for procedures performed in ASCs using the code C9290

As of October 1, 2024

EXPAREL is reimbursed at $1.45/mg*

Allowed amount for reimbursement:

$385.70†

266 mg (20 mL) dose

$192.85†

133 mg (10 mL) dose

For more information, contact our dedicated reimbursement specialists at reimbursement@pacira.com or call our Reimbursement Helpline at 1-855-793-9727.

ASC, ambulatory surgery center; CMS, Centers for Medicare and Medicaid Services; HCPCS, healthcare common procedure coding system.

*As of October 1, 2024; pricing 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.

Important Notice

Indication

EXPAREL® (bupivacaine liposome injectable suspension) is indicated to produce postsurgical local analgesia via infiltration in patients aged 6 years and older and regional analgesia in adults via an interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and an adductor canal block. Safety and efficacy have not been established in other nerve blocks.

Important Safety Information

  • EXPAREL is contraindicated in obstetrical paracervical block anesthesia.
  • Adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via infiltration were nausea, constipation, and vomiting; adverse reactions reported in adults with an incidence greater than or equal to 10% following EXPAREL administration via nerve block were nausea, pyrexia, headache, and constipation.
  • Adverse reactions with an incidence greater than or equal to 10% following EXPAREL administration via infiltration in pediatric patients six to less than 17 years of age were nausea, vomiting, constipation, hypotension, anemia, muscle twitching, vision blurred, pruritus, and tachycardia.
  • Do not admix lidocaine or other non-bupivacaine local anesthetics with EXPAREL. EXPAREL may be administered at least 20 minutes or more following local administration of lidocaine.
  • EXPAREL is not recommended to be used in the following patient populations: patients <6 years old for infiltration, patients younger than 18 years old for nerve blocks, and/or pregnant patients.
  • Because amide-type local anesthetics, such as bupivacaine, are metabolized by the liver, EXPAREL should be used cautiously in patients with hepatic disease.

Warnings and Precautions Specific to EXPAREL

  • Avoid additional use of local anesthetics within 96 hours following administration of EXPAREL.
  • EXPAREL is not recommended for the following types or routes of administration: epidural, intrathecal, regional nerve blocks other than interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and adductor canal block, or intravascular or intra-articular use.
  • The potential sensory and/or motor loss with EXPAREL is temporary and varies in degree and duration depending on the site of injection and dosage administered and may last for up to 5 days, as seen in clinical trials.

Warnings and Precautions for Bupivacaine-Containing Products

  • Central Nervous System (CNS) Reactions: There have been reports of adverse neurologic reactions with the use of local anesthetics. These include persistent anesthesia and paresthesia. CNS reactions are characterized by excitation and/or depression.
  • Cardiovascular System Reactions: Toxic blood concentrations depress cardiac conductivity and excitability, which may lead to dysrhythmias, sometimes leading to death.
  • Allergic Reactions: Allergic-type reactions (eg, anaphylaxis and angioedema) are rare and may occur as a result of hypersensitivity to the local anesthetic or to other formulation ingredients.
  • Chondrolysis: There have been reports of chondrolysis (mostly in the shoulder joint) following intra-articular infusion of local anesthetics, which is an unapproved use.
  • Methemoglobinemia: Cases of methemoglobinemia have been reported with local anesthetic use.

Please refer to full Prescribing Information.

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EXPAREL® (bupivacaine liposome injectable suspension) is indicated to produce postsurgical local analgesia via infiltration in patients aged 6 years and older and regional analgesia in adults via an interscalene brachial plexus nerve block, sciatic nerve block in the popliteal fossa, and an adductor canal block. Safety and efficacy have not been established in other nerve blocks.

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