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HCPCS J7040 · Level II · Part B drug

HCPCS J7040: Infusion, normal saline solution, sterile (500 ml = 1 unit)

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 J7040

Billing unit
500 ML
Normal saline solution infus
ASP payment limit
$1.385
October 2026; +2.6% vs July 2026
Practitioner MUE
6
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
1
3 states

TL;DR

HCPCS J7040 is the Level II code for Infusion, normal saline solution, sterile (500 ml = 1 unit), billed per 500 ML. The Medicare Part B ASP payment limit for October 2026 is $1.385 per billing unit, up 2.6% from July 2026. The practitioner MUE allows up to 6 units per date of service (MAI 3). Under OPPS it carries status indicator N. J7040 is billed in units of 500 ML; 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 43 NDCs to it, sold as Sodium Chloride by B. Braun Medical Inc., Baxter Healthcare Corporation, Pfizer 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 J7040 at $1.385 per 500 ML for October 2026, derived from manufacturer average sales price plus 6%, compared with $1.35 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J7040
QuarterPayment limitPerCoinsurance
October 2026$1.385500 ML20%
July 2026$1.35500 ML—
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 43 NDCs from 8 labelers to J7040. Report the NDC in the claim's drug segment and bill the number of J7040 units that equals the quantity administered divided by 500 ML; the last column gives units per full package.

NDCs that crosswalk to J7040
NDCDrug nameLabelerPackage sizeBilling units / package
00264-5802-00Sodium ChlorideB. Braun Medical Inc.1000 × 1224
00264-5802-10Sodium ChlorideB. Braun Medical Inc.500 × 2424
00264-7800-00Sodium ChlorideB. Braun Medical Inc.1000 × 1224
00264-7800-09Sodium ChlorideB. Braun Medical Inc.1000 × 1224
00264-7800-10Sodium ChlorideB. Braun Medical Inc.500 × 2424
00264-7800-20Sodium ChlorideB. Braun Medical Inc.250 × 2412
00338-0049-02Sodium ChlorideBaxter Healthcare Corporation250 × 11
00338-0049-03Sodium ChlorideBaxter Healthcare Corporation500 × 11
00338-0049-04Sodium ChlorideBaxter Healthcare Corporation1000 × 12
00338-9543-01Sodium ChlorideBaxter Healthcare Corporation250 × 3015
00338-9543-02Sodium ChlorideBaxter Healthcare Corporation250 × 11
00338-9543-03Sodium ChlorideBaxter Healthcare Corporation500 × 11
00338-9543-04Sodium ChlorideBaxter Healthcare Corporation500 × 2020
00338-9543-05Sodium ChlorideBaxter Healthcare Corporation1000 × 12
00338-9543-06Sodium ChlorideBaxter Healthcare Corporation1000 × 1020
00338-9791-40Sodium ChlorideBaxter Healthcare Corporation250 × 4020
00338-9793-12Sodium ChlorideBaxter Healthcare Corporation1000 × 1224
00338-9804-40Sodium ChlorideBaxter Healthcare Corporation250 × 4020
00338-9806-12Sodium ChlorideBaxter Healthcare Corporation1000 × 1224
00338-9808-24Sodium ChlorideBaxter Healthcare Corporation500 × 2424
00338-9810-24Sodium ChlorideBaxter Healthcare Corporation500 × 2424
00409-7101-02Sodium ChloridePfizer Inc250 × 2412
00487-4301-25Sodium ChlorideNephron SC, Inc.250 × 3518
00487-4301-50Sodium ChlorideNephron SC, Inc.500 × 1818
00990-7983-02Sodium ChlorideICu Medical Inc.250 × 2412
00990-7983-03Sodium ChlorideICu Medical Inc.500 × 2424
00990-7983-09Sodium ChlorideICu Medical Inc.1000 × 1224
00990-7983-55Sodium ChlorideICu Medical Inc.500 × 1818
51662-1517-01Sodium ChlorideHF Acquisition Co. LLC, DBA HealthFirst250 × 11
51662-1518-01Sodium ChlorideHF Acquisition Co. LLC, DBA HealthFirst1000 × 12
51662-1522-01Sodium ChlorideHF Acquisition Co. LLC, DBA HealthFirst500 × 11
63323-0623-74Sodium ChlorideFreseniUS Kabi USA, LLC250 × 3015
63323-0623-75Sodium ChlorideFreseniUS Kabi USA, LLC500 × 2020
63323-0623-76Sodium ChlorideFreseniUS Kabi USA, LLC1000 × 1020
65219-0222-25Sodium ChlorideFreseniUS Kabi USA, LLC1 × 3015
65219-0224-50Sodium ChlorideFreseniUS Kabi USA, LLC1 × 2020
65219-0282-10Sodium ChlorideFreseniUS Kabi USA, LLC1000 × 1020
65219-0470-30Sodium ChlorideFreseniUS Kabi USA, LLC250 × 3015
65219-0472-20Sodium ChlorideFreseniUS Kabi USA, LLC500 × 2020
65219-0474-10Sodium ChlorideFreseniUS Kabi USA, LLC1000 × 1020
70512-0841-26Sodium ChlorideSola Pharmaceuticals250 × 2814
70512-0841-51Sodium ChlorideSola Pharmaceuticals500 × 2020
70512-0841-61Sodium ChlorideSola Pharmaceuticals1000 × 1020

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J7040. For practitioners the limit is 6 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 J7040 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services63 Date of Service Edit: ClinicalClinical: Data
Facility outpatient hospital123 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 J7040 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.

J7040 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 J7040 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 J7040
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, J7040 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J7040 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 J7040 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 J7040

What does HCPCS code J7040 describe?

J7040 is defined by CMS as "Infusion, normal saline solution, sterile (500 ml = 1 unit)". Each billing unit represents 500 ML, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J7040 in October 2026?

The ASP-based payment limit is $1.385 per 500 ML, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $1.35.

How many units of J7040 can be billed per day?

The practitioner Medically Unlikely Edit is 6 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 "Clinical: Data" as the rationale.

Which NDCs map to J7040?

The October 2026 ASP crosswalk lists 43 NDCs from 8 labelers: Sodium Chloride (B. Braun Medical Inc.); Sodium Chloride (Baxter Healthcare Corporation); Sodium Chloride (Pfizer Inc); Sodium Chloride (Nephron SC, Inc.). For example NDC 00264-5802-00 is a 1000 package equal to 24 billing units. The crosswalk's billing-units-per-package figure converts each package into J7040 units.

Does J7040 have NCCI bundling edits?

No active practitioner PTP pairs list J7040 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 J7040?

1 current Billing and Coding Article in the Medicare Coverage Database list J7040, 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.