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HCPCS J2795 · Level II · Part B drug

HCPCS J2795: Injection, ropivacaine hydrochloride, 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 J2795

Billing unit
1 MG
Ropivacaine hcl injection
ASP payment limit
$0.04
October 2026; +2.6% vs July 2026
Practitioner MUE
200
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J2795 is the Level II code for Injection, ropivacaine hydrochloride, 1 mg, billed per 1 MG. The Medicare Part B ASP payment limit for October 2026 is $0.04 per billing unit, up 2.6% from July 2026. The practitioner MUE allows up to 200 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 98 NDCs to it, sold as Ropivacaine HCl, Ropivacaine, Naropin by Hikma Pharmaceuticals USA Inc., Henry Schein Inc., Sagent Pharmaceuticals. No current Billing and Coding Article lists J2795, 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 J2795 at $0.04 per 1 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.039 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J2795
QuarterPayment limitPerCoinsurance
October 2026$0.041 MG20%
July 2026$0.0391 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 98 NDCs from 17 labelers to J2795. Report the NDC in the claim's drug segment and bill the number of J2795 units that equals the quantity administered divided by 1 MG; the last column gives units per full package.

NDCs that crosswalk to J2795
NDCDrug nameLabelerPackage sizeBilling units / package
00143-9195-24Ropivacaine HClHikma Pharmaceuticals USA Inc.100 × 244800
00143-9263-10RopivacaineHikma Pharmaceuticals USA Inc.20 × 10400
00143-9264-10Ropivacaine HClHikma Pharmaceuticals USA Inc.30 × 101500
00143-9265-10Ropivacaine HClHikma Pharmaceuticals USA Inc.20 × 101500
00143-9266-10Ropivacaine HClHikma Pharmaceuticals USA Inc.20 × 102000
00404-9924-30NaropinHenry Schein Inc.30 × 1150
25021-0652-82RopivacaineSagent Pharmaceuticals100 × 105000
25021-0652-87RopivacaineSagent Pharmaceuticals200 × 1010000
25021-0671-66RopivacaineSagent Pharmaceuticals100 × 102000
25021-0671-67RopivacaineSagent Pharmaceuticals200 × 104000
25021-0671-82RopivacaineSagent Pharmaceuticals100 × 102000
25021-0671-87RopivacaineSagent Pharmaceuticals200 × 104000
43066-0015-10RopivacaineBaxter Healthcare Corporation20 × 10400
43066-0019-10RopivacaineBaxter Healthcare Corporation20 × 101000
43066-0023-10RopivacaineBaxter Healthcare Corporation30 × 101500
43066-0027-10RopivacaineBaxter Healthcare Corporation20 × 102000
43066-0152-10RopivacaineBaxter Healthcare Corporation100 × 102000
43066-0154-10RopivacaineBaxter Healthcare Corporation200 × 104000
52584-0286-35Ropivacaine HClHenry Schein Inc.30 × 1150
55150-0195-20RopivacaineEugia US LLC20 × 251000
55150-0196-99RopivacaineEugia US LLC100 × 1200
55150-0197-20RopivacaineEugia US LLC20 × 252500
55150-0198-30RopivacaineEugia US LLC30 × 253750
55150-0199-20RopivacaineEugia US LLC20 × 253750
55150-0200-10RopivacaineEugia US LLC10 × 252500
55150-0201-20RopivacaineEugia US LLC20 × 255000
63323-0285-10NaropinFreseniUS Kabi USA, LLC10 × 5100
63323-0285-13NaropinFreseniUS Kabi USA, LLC10 × 25500
63323-0285-20NaropinFreseniUS Kabi USA, LLC20 × 5200
63323-0285-23NaropinFreseniUS Kabi USA, LLC20 × 251000
63323-0285-28NaropinFreseniUS Kabi USA, LLC20 × 251000
63323-0285-61NaropinFreseniUS Kabi USA, LLC100 × 244800
63323-0285-63NaropinFreseniUS Kabi USA, LLC200 × 249600
63323-0285-64NaropinFreseniUS Kabi USA, LLC200 × 124800
63323-0285-65NaropinFreseniUS Kabi USA, LLC100 × 122400
63323-0285-67NaropinFreseniUS Kabi USA, LLC100 × 122400
63323-0285-68NaropinFreseniUS Kabi USA, LLC100 × 122400
63323-0285-73NaropinFreseniUS Kabi USA, LLC200 × 124800
63323-0286-00NaropinFreseniUS Kabi USA, LLC100 × 126000
63323-0286-20NaropinFreseniUS Kabi USA, LLC20 × 5500
63323-0286-23NaropinFreseniUS Kabi USA, LLC20 × 252500
63323-0286-27NaropinFreseniUS Kabi USA, LLC20 × 252500
63323-0286-35NaropinFreseniUS Kabi USA, LLC30 × 253750
63323-0286-38NaropinFreseniUS Kabi USA, LLC30 × 253750
63323-0286-63NaropinFreseniUS Kabi USA, LLC200 × 1212000
63323-0286-95NaropinFreseniUS Kabi USA, LLC30 × 253750
63323-0287-20NaropinFreseniUS Kabi USA, LLC20 × 5750
63323-0287-21NaropinFreseniUS Kabi USA, LLC20 × 253750
63323-0288-10NaropinFreseniUS Kabi USA, LLC10 × 5500
63323-0288-11NaropinFreseniUS Kabi USA, LLC10 × 252500
63323-0288-20NaropinFreseniUS Kabi USA, LLC20 × 51000
63323-0288-21NaropinFreseniUS Kabi USA, LLC20 × 255000
63323-0288-27NaropinFreseniUS Kabi USA, LLC20 × 51000
63323-0288-29NaropinFreseniUS Kabi USA, LLC20 × 255000
65145-0107-10Ropivacaine HClCaplin Steriles USA Inc.20 × 10400
65145-0108-10Ropivacaine HClCaplin Steriles USA Inc.20 × 101000
65145-0109-10Ropivacaine HClCaplin Steriles USA Inc.30 × 101500
65145-0110-10Ropivacaine HClCaplin Steriles USA Inc.20 × 102000
65145-0165-01Ropivacaine HClCaplin Steriles USA Inc.100 × 1200
65145-0165-10Ropivacaine HClCaplin Steriles USA Inc.100 × 102000
Showing 60 of 98 NDCs.

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J2795. For practitioners the limit is 200 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 J2795 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services2003 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital24003 Date of Service Edit: ClinicalClinical: Data
DME supplier03 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J2795 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.

J2795 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 J2795 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, J2795 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J2795 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 J2795 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.

Explore QuickCodeExplore QuickRCMBook a demo

Frequently asked questions — HCPCS J2795

What does HCPCS code J2795 describe?

J2795 is defined by CMS as "Injection, ropivacaine hydrochloride, 1 mg". Each billing unit represents 1 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J2795 in October 2026?

The ASP-based payment limit is $0.04 per 1 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.039.

How many units of J2795 can be billed per day?

The practitioner Medically Unlikely Edit is 200 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 "Prescribing Information" as the rationale.

Which NDCs map to J2795?

The October 2026 ASP crosswalk lists 98 NDCs from 17 labelers: Ropivacaine HCl (Hikma Pharmaceuticals USA Inc.); Ropivacaine (Hikma Pharmaceuticals USA Inc.); Naropin (Henry Schein Inc.); Ropivacaine (Sagent Pharmaceuticals). For example NDC 00143-9195-24 is a 100 package equal to 4800 billing units. The crosswalk's billing-units-per-package figure converts each package into J2795 units.

Does J2795 have NCCI bundling edits?

No active practitioner PTP pairs list J2795 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.