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HCPCS J1596 · Level II · Part B drug

HCPCS J1596: Injection, glycopyrrolate, 0.1 mg

Reviewed by QuickIntell RCM Editorial Team · Last reviewed

Data effective
Data currency: ASP payment limits October 2026 (effective October 1, 2026); MUE and NCCI edits 2026 Q4 (effective October 1, 2026); OPPS Addendum B July 2026 (effective July 1, 2026). Next CMS release: January 1, 2027 (ASP, MUE, NCCI and OPPS quarterly updates).

Key facts for J1596

Billing unit
0.1 MG
Inj, glycopyrrolate, 0.1 mg
ASP payment limit
$0.33
October 2026; -9.6% vs July 2026
Practitioner MUE
18
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J1596 is the Level II code for Injection, glycopyrrolate, 0.1 mg, billed per 0.1 MG. The Medicare Part B ASP payment limit for October 2026 is $0.33 per billing unit, down 9.6% from July 2026. The practitioner MUE allows up to 18 units per date of service (MAI 3). Under OPPS it carries status indicator N. With a 1 mg billing unit, a single administration can be hundreds of units; the unit count on the claim must equal the milligrams given, and rounding rules for partial units follow the contractor's guidance. The ASP crosswalk maps 86 NDCs to it, sold as Glycopyrrolate Injection by Hikma Pharmaceuticals USA Inc., Henry Schein Inc., American Regent, Inc.. No current Billing and Coding Article lists J1596, so coverage follows the FDA label, compendia and any applicable NCD.

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J1596 at $0.33 per 0.1 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.365 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J1596
QuarterPayment limitPerCoinsurance
October 2026$0.330.1 MG20%
July 2026$0.3650.1 MG—
Source: CMS Medicare Part B Drug Payment Limit File. Commercial and Medicaid payers set their own rates.

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 86 NDCs from 18 labelers to J1596. Report the NDC in the claim's drug segment and bill the number of J1596 units that equals the quantity administered divided by 0.1 MG; the last column gives units per full package.

NDCs that crosswalk to J1596
NDCDrug nameLabelerPackage sizeBilling units / package
00143-9584-10Glycopyrrolate InjectionHikma Pharmaceuticals USA Inc.20 × 10400
00143-9585-25Glycopyrrolate InjectionHikma Pharmaceuticals USA Inc.5 × 25250
00143-9586-25Glycopyrrolate InjectionHikma Pharmaceuticals USA Inc.2 × 25100
00143-9587-25Glycopyrrolate InjectionHikma Pharmaceuticals USA Inc.1 × 2550
00143-9679-10Glycopyrrolate InjectionHikma Pharmaceuticals USA Inc.20 × 10400
00143-9680-25Glycopyrrolate InjectionHikma Pharmaceuticals USA Inc.5 × 25250
00143-9681-25Glycopyrrolate InjectionHikma Pharmaceuticals USA Inc.2 × 25100
00143-9682-25Glycopyrrolate InjectionHikma Pharmaceuticals USA Inc.1 × 2550
00404-9775-01Glycopyrrolate InjectionHenry Schein Inc.1 × 12
00404-9776-05Glycopyrrolate InjectionHenry Schein Inc.5 × 110
00404-9777-20Glycopyrrolate InjectionHenry Schein Inc.20 × 140
00404-9782-02Glycopyrrolate InjectionHenry Schein Inc.2 × 14
00404-9867-01Glycopyrrolate InjectionHenry Schein Inc.1 × 12
00404-9868-20Glycopyrrolate InjectionHenry Schein Inc.20 × 140
00404-9869-02Glycopyrrolate InjectionHenry Schein Inc.2 × 14
00404-9870-05Glycopyrrolate InjectionHenry Schein Inc.5 × 110
00517-4601-25Glycopyrrolate InjectionAmerican Regent, Inc.1 × 2550
00517-4602-25Glycopyrrolate InjectionAmerican Regent, Inc.2 × 25100
00517-4605-25Glycopyrrolate InjectionAmerican Regent, Inc.5 × 25250
00517-4620-25Glycopyrrolate InjectionAmerican Regent, Inc.20 × 251000
00641-6212-10Glycopyrrolate InjectionHikma Pharmaceuticals USA Inc.1 × 1020
00641-6213-10Glycopyrrolate InjectionHikma Pharmaceuticals USA Inc.2 × 1040
00781-3825-96Glycopyrrolate InjectionSandoz Inc.1 × 2550
00781-3827-96Glycopyrrolate InjectionSandoz Inc.2 × 25100
00781-3829-96Glycopyrrolate InjectionSandoz Inc.5 × 25250
00781-3831-95Glycopyrrolate InjectionSandoz Inc.20 × 10400
25021-0796-01Glycopyrrolate InjectionSagent Pharmaceuticals1 × 2550
25021-0796-02Glycopyrrolate InjectionSagent Pharmaceuticals2 × 25100
25021-0796-05Glycopyrrolate InjectionSagent Pharmaceuticals5 × 25250
50090-4513-00Glycopyrrolate InjectionA-S Medication Solutions1 × 12
50090-5226-00Glycopyrrolate InjectionA-S Medication Solutions1 × 2550
51662-1487-01Glycopyrrolate InjectionHF Acquisition Co. LLC, DBA HealthFirst1 × 12
51662-1487-03Glycopyrrolate InjectionHF Acquisition Co. LLC, DBA HealthFirst1 × 2550
51662-1554-03Glycopyrrolate InjectionHF Acquisition Co. LLC, DBA HealthFirst2 × 25100
51662-1601-01Glycopyrrolate InjectionHF Acquisition Co. LLC, DBA HealthFirst5 × 110
51662-1601-03Glycopyrrolate InjectionHF Acquisition Co. LLC, DBA HealthFirst5 × 25250
60505-6179-05Glycopyrrolate InjectionApotex Corp1 × 2550
60505-6180-05Glycopyrrolate InjectionApotex Corp2 × 25100
60505-6181-05Glycopyrrolate InjectionApotex Corp5 × 25250
60505-6182-04Glycopyrrolate InjectionApotex Corp20 × 10400
62332-0607-25Glycopyrrolate InjectionAlembic Pharmaceuticals Inc.1 × 2550
62332-0627-25Glycopyrrolate InjectionAlembic Pharmaceuticals Inc.2 × 25100
62332-0628-25Glycopyrrolate InjectionAlembic Pharmaceuticals Inc.5 × 25250
62332-0629-10Glycopyrrolate InjectionAlembic Pharmaceuticals Inc.20 × 10400
63323-0578-01Glycopyrrolate InjectionFreseniUS Kabi USA, LLC1 × 2550
63323-0578-02Glycopyrrolate InjectionFreseniUS Kabi USA, LLC2 × 25100
63323-0578-05Glycopyrrolate InjectionFreseniUS Kabi USA, LLC5 × 25250
63323-0578-11Glycopyrrolate InjectionFreseniUS Kabi USA, LLC1 × 2550
63323-0578-12Glycopyrrolate InjectionFreseniUS Kabi USA, LLC2 × 25100
65219-0801-01Glycopyrrolate InjectionFreseniUS Kabi USA, LLC1 × 2550
66794-0202-42Glycopyrrolate InjectionPiramal Critical Care Inc1 × 2550
66794-0203-42Glycopyrrolate InjectionPiramal Critical Care Inc2 × 25100
66794-0204-42Glycopyrrolate InjectionPiramal Critical Care Inc5 × 25250
66794-0205-41Glycopyrrolate InjectionPiramal Critical Care Inc20 × 10400
70069-0616-10Glycopyrrolate InjectionSomerset Pharma, LLC20 × 10400
70069-0617-25Glycopyrrolate InjectionSomerset Pharma, LLC1 × 2550
70069-0618-25Glycopyrrolate InjectionSomerset Pharma, LLC2 × 25100
70069-0619-25Glycopyrrolate InjectionSomerset Pharma, LLC5 × 25250
70121-1698-07Glycopyrrolate InjectionAmneal Pharmaceuticals, LLC1 × 1020
70121-1699-07Glycopyrrolate InjectionAmneal Pharmaceuticals, LLC2 × 1040
Showing 60 of 86 NDCs.

Medically Unlikely Edits (MUE)

CMS publishes 2 MUE values for J1596. For practitioners the limit is 18 units per date of service with adjudication indicator 3, a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation that the quantity was medically reasonable.

MUE values for J1596 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services183 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital183 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J1596 as a column-1 or column-2 code in v323r0. Drug supply codes are rarely bundled; the administration codes billed with them are where PTP edits usually apply.

J1596 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

No current Billing and Coding Article lists J1596 in its HCPCS table. Coverage then follows the drug's FDA label, compendia and any National Coverage Determination; check the Medicare Coverage Database before administering off-label.

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J1596 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J1596 and how to prevent them

CARC 16 · M119

NDC missing, invalid or not matched to the HCPCS code

CARC 151 · N362

units billed exceed the MUE for the date of service

CARC 50 · N115

diagnosis not covered by the applicable coverage article or LCD

How QuickIntell checks J1596 before the claim leaves

QuickCode validates the NDC-to-unit conversion against the current ASP crosswalk, checks units against every published MUE setting and flags PTP and add-on conflicts on the same claim. QuickRCM routes CARC 16, 151 and 50 denials on drug lines with the matching coverage article attached so the appeal starts with evidence.

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Frequently asked questions — HCPCS J1596

What does HCPCS code J1596 describe?

J1596 is defined by CMS as "Injection, glycopyrrolate, 0.1 mg". Each billing unit represents 0.1 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J1596 in October 2026?

The ASP-based payment limit is $0.33 per 0.1 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.365.

How many units of J1596 can be billed per day?

The practitioner Medically Unlikely Edit is 18 units per date of service with adjudication indicator 3 (3 Date of Service Edit: Clinical). MAI 3 edits can be appealed with documentation that the units were medically reasonable. CMS cites "CMS Policy" as the rationale.

Which NDCs map to J1596?

The October 2026 ASP crosswalk lists 86 NDCs from 18 labelers: Glycopyrrolate Injection (Hikma Pharmaceuticals USA Inc.); Glycopyrrolate Injection (Henry Schein Inc.); Glycopyrrolate Injection (American Regent, Inc.); Glycopyrrolate Injection (Sandoz Inc.). For example NDC 00143-9584-10 is a 20 package equal to 400 billing units. The crosswalk's billing-units-per-package figure converts each package into J1596 units.

Does J1596 have NCCI bundling edits?

No active practitioner PTP pairs list J1596 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-01. Verify against the primary file before billing or contracting decisions.

Disclaimer

This page is an operational reference compiled from CMS publications: the Medicare Part B drug payment limit and NDC crosswalk files, NCCI MUE and add-on edit tables, aggregate PTP statistics, OPPS Addendum B and the Medicare Coverage Database. Payment limits are Medicare national amounts; commercial and Medicaid payers differ. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.