Brand J7520 · Immunosuppressants

SIROLIMUS 0.5 MG TABLET

SIROLIMUS 0.5 MG TABLET has a NADAC acquisition cost of $2.49, though hospitals typically charge patients 5-15 times more than this immunosuppressant medication's wholesale price.

By Kevin Nyk , Medical Billing Analyst · Published March 15, 2026 · Updated April 3, 2026

Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.

About the analyst

Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.

NADAC acquisition cost data

CMS drug pricing benchmarks

Updated 2026-04-03

Drug acquisition cost — SIROLIMUS 0.5 MG TABLET

Hospital charges for this drug vary — typically 3–8x the acquisition cost. No observed hospital charge data is available for this specific drug.

$2.49

NADAC acquisition cost

TABLET

Dosage form

ORAL

Route

Sirolimus is an immunosuppressant medication primarily used to prevent organ rejection in transplant patients and treat certain rare diseases. This brand-name formulation typically generates higher reimbursement rates compared to generic alternatives when available through specialty pharmacy networks.

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Research suggests 49–80% of hospital bills contain errors. Our system checks every line item against Medicare benchmarks.

Common billing errors — Immunosuppressants charges

Immunosuppressant billing errors frequently involve significant charges above the benchmark, with hospital markups ranging from 200-800% over the $3.20 average NADAC acquisition cost. Duplicate billing commonly occurs when patients receive both brand-name and generic versions of the same immunosuppressant during transitions between formulations, particularly with drugs like tacrolimus or mycophenolate. Generic substitution issues arise when hospitals bill for brand-name drugs but dispense generics without adjusting charges accordingly, creating substantial potential differences in patient costs. Additionally, dosage consolidation errors appear when multiple smaller-dose administrations are billed separately rather than as equivalent single doses, inflating total charges. Patients should verify that billing reflects actual medications received and confirm that generic substitutions, when clinically appropriate, are reflected in the final charges rather than brand-name pricing.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — Immunosuppressants billing

What is the average acquisition cost for immunosuppressant drugs?

The average NADAC (National Average Drug Acquisition Cost) for immunosuppressant drugs is $3.20. This benchmark represents the national average price that pharmacies pay to acquire these medications from wholesalers or manufacturers.

How many different immunosuppressant drugs are tracked in billing systems?

There are 21 different drugs classified as immunosuppressants that are commonly tracked in pharmaceutical billing systems. This drug class includes various medications used to suppress immune system activity in transplant patients and autoimmune conditions.

How should billing departments handle immunosuppressant drug cost variations?

Billing departments should compare actual drug acquisition costs against the $3.20 NADAC benchmark to identify potential differences in pricing. Any charges above the benchmark should be documented and reviewed as part of standard cost analysis procedures.

What billing considerations apply specifically to immunosuppressant medications?

Immunosuppressant drugs often require prior authorization and may have specific coverage criteria that affect billing processes. The relatively low average NADAC cost of $3.20 suggests these are generally standard-tier medications, though individual drug costs within the class may vary significantly.

Related pricing data

More Immunosuppressants drugs

Data source: National Average Drug Acquisition Cost (NADAC) survey, published by CMS. HCPCS drug pricing codes from Medicare Part B Drug Average Sales Price file.

What NADAC means: The average price pharmacies pay to acquire this drug from wholesalers. Hospital charges for the same drug are typically higher due to facility fees, compounding, and administration costs.

Limitations: NADAC reflects pharmacy acquisition cost, not patient out-of-pocket cost. Insurance copays, formulary tiers, and manufacturer rebates affect what patients actually pay.