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HCPCS J2919 · Level II · Part B drug

HCPCS J2919: Injection, methylprednisolone sodium succinate, 5 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 J2919

Billing unit
5 MG
Inj, methylpred sod succ 5mg
ASP payment limit
$0.255
October 2026; +13.8% vs July 2026
Practitioner MUE
5400
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
1
3 states

TL;DR

HCPCS J2919 is the Level II code for Injection, methylprednisolone sodium succinate, 5 mg, billed per 5 MG. The Medicare Part B ASP payment limit for October 2026 is $0.255 per billing unit, up 13.8% from July 2026. The practitioner MUE allows up to 5400 units per date of service (MAI 3). Under OPPS it carries status indicator N. J2919 is billed in units of 5 MG; 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 33 NDCs to it, sold as Solu-Medrol, Methylprednisolone Sodium Succ, Methylprednisolone Sodium Succinate by Pfizer Inc, Hikma Pharmaceuticals USA Inc., Henry Schein Inc.. 1 Medicare coverage article lists the code across 3 states, including .

Medicare Part B payment limit (ASP)

CMS sets the Part B payment limit for J2919 at $0.255 per 5 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.224 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J2919
QuarterPayment limitPerCoinsurance
October 2026$0.2555 MG20%
July 2026$0.2245 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 33 NDCs from 8 labelers to J2919. Report the NDC in the claim's drug segment and bill the number of J2919 units that equals the quantity administered divided by 5 MG; the last column gives units per full package.

NDCs that crosswalk to J2919
NDCDrug nameLabelerPackage sizeBilling units / package
00009-0003-02Solu-MedrolPfizer Inc1 × 1100
00009-0018-20Solu-MedrolPfizer Inc1 × 1200
00009-0039-06Solu-MedrolPfizer Inc1 × 25200
00009-0039-28Solu-MedrolPfizer Inc1 × 25200
00009-0039-32Solu-MedrolPfizer Inc1 × 25200
00009-0047-04Solu-MedrolPfizer Inc1 × 25625
00009-0047-22Solu-MedrolPfizer Inc1 × 25625
00009-0047-26Solu-MedrolPfizer Inc1 × 25625
00009-0698-01Solu-MedrolPfizer Inc1 × 1200
00009-0698-02Solu-MedrolPfizer Inc1 × 1200
00009-0758-01Solu-MedrolPfizer Inc1 × 1100
00009-0850-01Solu-MedrolPfizer Inc1 × 1400
00143-9753-25Methylprednisolone Sodium SuccHikma Pharmaceuticals USA Inc.1 × 25200
00143-9754-25Methylprednisolone Sodium SuccHikma Pharmaceuticals USA Inc.1 × 25625
00143-9850-01Methylprednisolone Sodium SuccHikma Pharmaceuticals USA Inc.1 × 1100
00143-9851-01Methylprednisolone Sodium SuccHikma Pharmaceuticals USA Inc.1 × 1200
00404-9957-02Solu-MedrolHenry Schein Inc.1 × 125
00404-9958-01Solu-MedrolHenry Schein Inc.1 × 18
43598-0127-25Methylprednisolone Sodium SuccDr. Reddy's Laboratories Inc.1 × 25200
43598-0128-11Methylprednisolone Sodium SuccDr. Reddy's Laboratories Inc.1 × 1100
43598-0129-25Methylprednisolone Sodium SuccDr. Reddy's Laboratories Inc.1 × 25625
43598-0130-74Methylprednisolone Sodium SuccDr. Reddy's Laboratories Inc.1 × 1200
50090-0271-00Solu-MedrolA-S Medication Solutions1 × 125
50090-0271-01Solu-MedrolA-S Medication Solutions1 × 25625
51662-1263-01Solu-MedrolHF Acquisition Co. LLC, DBA HealthFirst1 × 125
51662-1263-03Solu-MedrolHF Acquisition Co. LLC, DBA HealthFirst1 × 25625
51662-1264-01Solu-MedrolHF Acquisition Co. LLC, DBA HealthFirst1 × 18
51662-1264-03Solu-MedrolHF Acquisition Co. LLC, DBA HealthFirst1 × 25200
63323-0255-03Methylprednisolone Sodium SuccFreseniUS Kabi USA, LLC1 × 25200
63323-0258-03Methylprednisolone Sodium SuccFreseniUS Kabi USA, LLC1 × 25625
63323-0265-30Methylprednisolone Sodium SuccFreseniUS Kabi USA, LLC1 × 1200
72572-0097-25Methylprednisolone Sodium SuccinateCivica, Inc.1 × 25200
72572-0098-25Methylprednisolone Sodium SuccinateCivica, Inc.1 × 25625

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J2919. For practitioners the limit is 5400 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 J2919 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services54003 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital54003 Date of Service Edit: ClinicalPrescribing Information
DME supplier54003 Date of Service Edit: ClinicalPrescribing Information

NCCI edits and add-on relationships

No active practitioner PTP pair lists J2919 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.

J2919 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Medicare coverage articles

1 current Medicare Administrative Contractor article lists J2919 in their HCPCS tables, covering 3 states. Each article carries the covered and non-covered ICD-10 codes that medical-necessity denials (CARC 50) are adjudicated against.

Billing and Coding Articles listing J2919
ArticleTitleContractor(s)StatesRelated LCD
Billing and Coding: Trigger Point InjectionsFirst Coast Service Options, Inc.FL PR VIL33912

Hospital outpatient (OPPS) status

In the July 2026 OPPS Addendum B, J2919 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J2919 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 J2919 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 J2919

What does HCPCS code J2919 describe?

J2919 is defined by CMS as "Injection, methylprednisolone sodium succinate, 5 mg". Each billing unit represents 5 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J2919 in October 2026?

The ASP-based payment limit is $0.255 per 5 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.224.

How many units of J2919 can be billed per day?

The practitioner Medically Unlikely Edit is 5400 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 J2919?

The October 2026 ASP crosswalk lists 33 NDCs from 8 labelers: Solu-Medrol (Pfizer Inc); Methylprednisolone Sodium Succ (Hikma Pharmaceuticals USA Inc.); Solu-Medrol (Henry Schein Inc.); Methylprednisolone Sodium Succ (Dr. Reddy's Laboratories Inc.). For example NDC 00009-0003-02 is a 1 package equal to 100 billing units. The crosswalk's billing-units-per-package figure converts each package into J2919 units.

Does J2919 have NCCI bundling edits?

No active practitioner PTP pairs list J2919 as a column-1 or column-2 code in the v323r0 release. Unit limits (MUE) and medical-necessity coverage rules still apply.

Which Medicare coverage articles mention J2919?

1 current Billing and Coding Article in the Medicare Coverage Database list J2919, covering 3 states: (Billing and Coding: Trigger Point Injections).

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.