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HCPCS J2371 · Level II · Part B drug

HCPCS J2371: Injection, phenylephrine hydrochloride, 20 micrograms

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 J2371

Billing unit
20 MCG
Inj phenylephrine hcl 20 mcg
ASP payment limit
$0.002
October 2026; +0.0% vs July 2026
Practitioner MUE
none published
CMS publishes no MUE for this code
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J2371 is the Level II code for Injection, phenylephrine hydrochloride, 20 micrograms, billed per 20 MCG. The Medicare Part B ASP payment limit for October 2026 is $0.002 per billing unit, up 0.0% from July 2026. Under OPPS it carries status indicator N. J2371 is billed in units of 20 MCG; the quantity administered, the NDC package and the units on the claim must reconcile, which is the check that prevents CARC 16 and 151 returns on this line. The ASP crosswalk maps 57 NDCs to it, sold as Phenylephrine HCl by Henry Schein Inc., Hikma Pharmaceuticals USA Inc., Sandoz Inc.. No current Billing and Coding Article lists J2371, 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 J2371 at $0.002 per 20 MCG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.002 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J2371
QuarterPayment limitPerCoinsurance
October 2026$0.00220 MCG20%
July 2026$0.00220 MCG—
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 57 NDCs from 20 labelers to J2371. Report the NDC in the claim's drug segment and bill the number of J2371 units that equals the quantity administered divided by 20 MCG; the last column gives units per full package.

NDCs that crosswalk to J2371
NDCDrug nameLabelerPackage sizeBilling units / package
00404-9931-99Phenylephrine HClHenry Schein Inc.1 × 1500
00641-6142-25Phenylephrine HClHikma Pharmaceuticals USA Inc.1 × 2512500
00641-6188-10Phenylephrine HClHikma Pharmaceuticals USA Inc.5 × 1025000
00641-6189-10Phenylephrine HClHikma Pharmaceuticals USA Inc.10 × 1050000
00641-6229-25Phenylephrine HClHikma Pharmaceuticals USA Inc.1 × 2512500
00781-3422-92Phenylephrine HClSandoz Inc.1 × 105000
00781-3458-95Phenylephrine HClSandoz Inc.5 × 1025000
00781-3466-70Phenylephrine HClSandoz Inc.10 × 15000
00781-9227-95Phenylephrine HClSandoz Inc.5 × 1025000
00781-9228-70Phenylephrine HClSandoz Inc.10 × 15000
23155-0620-41Phenylephrine HClHeritage Pharmaceuticals Inc.1 × 2512500
25021-0315-01Phenylephrine HClSagent Pharmaceuticals1 × 2512500
25021-0315-98Phenylephrine HClSagent Pharmaceuticals10 × 15000
25021-0315-99Phenylephrine HClSagent Pharmaceuticals5 × 1025000
42023-0214-10Phenylephrine HClEndo USA, Inc.5 × 1025000
42023-0215-01Phenylephrine HClEndo USA, Inc.10 × 15000
51662-1249-01Phenylephrine HClHF Acquisition Co. LLC, DBA HealthFirst1 × 1500
51662-1576-03Phenylephrine HClHF Acquisition Co. LLC, DBA HealthFirst1 × 2512500
55150-0300-25Phenylephrine HClEugia US LLC1 × 2512500
55150-0301-10Phenylephrine HClEugia US LLC5 × 1025000
55150-0302-01Phenylephrine HClEugia US LLC10 × 15000
61990-0211-03Phenylephrine HClApollo Pharmaceuticals Inc.1 × 2512500
61990-0212-02Phenylephrine HClApollo Pharmaceuticals Inc.5 × 1025000
61990-0213-01Phenylephrine HClApollo Pharmaceuticals Inc.10 × 15000
63037-0173-25Phenylephrine HClHikma Injectables USA Inc.10 × 251250
63037-0174-25Phenylephrine HClHikma Injectables USA Inc.5 × 25625
63323-0751-01Phenylephrine HClFreseniUS Kabi USA, LLC1 × 2512500
63323-0751-05Phenylephrine HClFreseniUS Kabi USA, LLC5 × 12500
63323-0751-10Phenylephrine HClFreseniUS Kabi USA, LLC10 × 15000
63323-0751-13Phenylephrine HClFreseniUS Kabi USA, LLC1 × 2512500
65145-0115-25Phenylephrine HClCaplin Steriles USA Inc.1 × 2512500
70069-0801-25Phenylephrine HClSomerset Pharma, LLC1 × 2512500
70069-0802-10Phenylephrine HClSomerset Pharma, LLC5 × 1025000
70069-0803-01Phenylephrine HClSomerset Pharma, LLC10 × 15000
70069-0811-25Phenylephrine HClSomerset Pharma, LLC1 × 2512500
70069-0812-10Phenylephrine HClSomerset Pharma, LLC5 × 1025000
70069-0813-01Phenylephrine HClSomerset Pharma, LLC10 × 15000
70121-1577-05Phenylephrine HClAmneal Pharmaceuticals, LLC1 × 2512500
70121-1578-07Phenylephrine HClAmneal Pharmaceuticals, LLC5 × 1025000
70121-1579-01Phenylephrine HClAmneal Pharmaceuticals, LLC10 × 15000
70756-0621-25Phenylephrine HClLifestar Pharma1 × 2512500
70756-0622-10Phenylephrine HClLifestar Pharma5 × 1025000
70756-0623-86Phenylephrine HClLifestar Pharma10 × 15000
71288-0807-02Phenylephrine HClMeitheal Pharmaceuticals Inc.1 × 2512500
71288-0808-76Phenylephrine HClMeitheal Pharmaceuticals Inc.5 × 1025000
71288-0808-77Phenylephrine HClMeitheal Pharmaceuticals Inc.10 × 15000
72205-0264-25Phenylephrine HClNovadoz Pharmaceuticals LLC1 × 2512500
72205-0265-07Phenylephrine HClNovadoz Pharmaceuticals LLC5 × 1025000
72205-0266-07Phenylephrine HClNovadoz Pharmaceuticals LLC10 × 1050000
72485-0504-25Phenylephrine HClArmas Pharmaceuticals Inc.1 × 2512500
72485-0505-10Phenylephrine HClArmas Pharmaceuticals Inc.5 × 1025000
72485-0506-01Phenylephrine HClArmas Pharmaceuticals Inc.10 × 15000
72572-0570-10Phenylephrine HClCivica, Inc.10 × 1050000
72572-0571-25Phenylephrine HClCivica, Inc.1 × 2512500
81284-0211-25Phenylephrine HClApollo Pharmaceuticals1 × 2512500
81284-0212-10Phenylephrine HClApollo Pharmaceuticals5 × 1025000
81284-0213-01Phenylephrine HClApollo Pharmaceuticals10 × 15000

Medically Unlikely Edits (MUE)

CMS does not publish an MUE for J2371 in the 2026 Q4 tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the dose and the units calculation on every claim.

NCCI edits and add-on relationships

No active practitioner PTP pair lists J2371 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.

J2371 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 J2371 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, J2371 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J2371 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 J2371 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 J2371

What does HCPCS code J2371 describe?

J2371 is defined by CMS as "Injection, phenylephrine hydrochloride, 20 micrograms". Each billing unit represents 20 MCG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J2371 in October 2026?

The ASP-based payment limit is $0.002 per 20 MCG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.002.

Which NDCs map to J2371?

The October 2026 ASP crosswalk lists 57 NDCs from 20 labelers: Phenylephrine HCl (Henry Schein Inc.); Phenylephrine HCl (Hikma Pharmaceuticals USA Inc.); Phenylephrine HCl (Sandoz Inc.); Phenylephrine HCl (Heritage Pharmaceuticals Inc.). For example NDC 00404-9931-99 is a 1 package equal to 500 billing units. The crosswalk's billing-units-per-package figure converts each package into J2371 units.

Does J2371 have NCCI bundling edits?

No active practitioner PTP pairs list J2371 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 2026-10-02. 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.