Key facts for J7332
- Billing unit
- 1 MG
- Inj., triluron, 1 mg
- ASP payment limit
- $10.188
- October 2026; -2.3% vs July 2026
- Practitioner MUE
- 40
- MAI 3
- OPPS status
- SI K
- APC 9338
- NCCI exposure
- no PTP pairs
- Coverage articles
- 1
- 5 states
TL;DR
HCPCS J7332 is the Level II code for Hyaluronan or derivative, triluron, for intra-articular injection, 1 mg, billed per 1 MG. The Medicare Part B ASP payment limit for October 2026 is $10.188 per billing unit, down 2.3% from July 2026. The practitioner MUE allows up to 40 units per date of service (MAI 3). Under OPPS it carries status indicator K in APC 9338. 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. Site-specific administration routes in the descriptor tie the drug to a particular procedure code; the pairing is where NCCI column-1/column-2 edits and modifier decisions arise. The ASP crosswalk maps 1 NDC to it, sold as Triluron by Fidia Pharma USA Inc. 1 Medicare coverage article lists the code across 5 states, including .
Medicare Part B payment limit (ASP)
CMS sets the Part B payment limit for J7332 at $10.188 per 1 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $10.43 in July 2026. Beneficiary coinsurance is 20%.
| Quarter | Payment limit | Per | Coinsurance |
|---|---|---|---|
| October 2026 | $10.188 | 1 MG | 20% |
| July 2026 | $10.43 | 1 MG | — |
NDC to HCPCS billing-unit conversion
The October 2026 ASP crosswalk maps 1 NDC from 1 labeler to J7332. Report the NDC in the claim's drug segment and bill the number of J7332 units that equals the quantity administered divided by 1 MG; the last column gives units per full package.
| NDC | Drug name | Labeler | Package size | Billing units / package |
|---|---|---|---|---|
| 89122-0879-01 | Triluron | Fidia Pharma USA Inc | 2 × 1 | 20 |
Medically Unlikely Edits (MUE)
CMS publishes 2 MUE values for J7332. For practitioners the limit is 40 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.
| Setting | MUE (units/DOS) | MAI | CMS rationale |
|---|---|---|---|
| Practitioner services | 40 | 3 Date of Service Edit: Clinical | Prescribing Information |
| Facility outpatient hospital | 40 | 3 Date of Service Edit: Clinical | Prescribing Information |
NCCI edits and add-on relationships
No active practitioner PTP pair lists J7332 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.
J7332 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 J7332 in their HCPCS tables, covering 5 states. Each article carries the covered and non-covered ICD-10 codes that medical-necessity denials (CARC 50) are adjudicated against.
Hospital outpatient (OPPS) status
In the July 2026 OPPS Addendum B, J7332 carries status indicator K and is assigned to APC 9338, with a published national unadjusted payment of $10.43. Status K means the drug is paid separately under OPPS at the ASP-based rate rather than packaged into the procedure.
Common denials for J7332 and how to prevent them
How QuickIntell checks J7332 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.
Frequently asked questions — HCPCS J7332
What does HCPCS code J7332 describe?
J7332 is defined by CMS as "Hyaluronan or derivative, triluron, for intra-articular injection, 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 J7332 in October 2026?
The ASP-based payment limit is $10.188 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 $10.43.
How many units of J7332 can be billed per day?
The practitioner Medically Unlikely Edit is 40 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 J7332?
The October 2026 ASP crosswalk lists 1 NDC from 1 labeler: Triluron (Fidia Pharma USA Inc). For example NDC 89122-0879-01 is a 2 package equal to 20 billing units. The crosswalk's billing-units-per-package figure converts each package into J7332 units.
Does J7332 have NCCI bundling edits?
No active practitioner PTP pairs list J7332 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 J7332?
1 current Billing and Coding Article in the Medicare Coverage Database list J7332, covering 5 states: (Billing and Coding: Hyaluronans Intra-articular Injections of).
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.
- HCPCS Level II alpha-numeric file, October 2026Version October 2026 · effective 2026-10-01 · file HCPC2026_OCT_ANWEB_09232026.txtSHA-256 c25240c63108756d…
- Medicare Part B Drug Payment Limit File, October 2026Version October 2026 · effective 2026-10-01 · file section 508 version of October 2026 Medicare Part B Payment Limit File 091626.csvSHA-256 508fba376a29e099…
- Medicare Part B Drug Payment Limit File, July 2026Version July 2026 · effective 2026-07-01 · file section 508 version of July 2026 Medicare Part B Payment Limit File updated 082026.csvSHA-256 13bb5b644b92b574…
- ASP NDC-HCPCS Crosswalk, October 2026Version October 2026 · effective 2026-10-01 · file section 508 version of October 2026 ASP NDC-HCPCS Crosswalk 091126.csvSHA-256 5cb78f0c2ee786ba…
- NCCI MUE table, practitioner services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_PractitionerServices_Eff_10-01-2026.csvSHA-256 ef038efaf902b7bd…
- NCCI MUE table, facility services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_OutpatientHospitalServices_Eff_10-01-2026.csvSHA-256 3af9f4e99cc587e2…
- NCCI MUE table, dme services, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file MCR_MUE_DMESupplierServices_Eff_10-01-2026.csvSHA-256 6fa4fbba852f7b74…
- NCCI PTP edits, practitioner, v323r0 (four files)Version v323r0 (2026 Q4) · effective 2026-10-01 · file ccipra-v323r0-f1.TXTSHA-256 7793c0b6686c1e22…
- NCCI Add-On Code edits, effective 2026-10-01Version 2026 Q4 · effective 2026-10-01 · file AOC_V2026Q4-F-MCR.txtSHA-256 3c92860fb5001967…
- OPPS Addendum B, July 2026Version July 2026 · effective 2026-07-01 · file 2026 July Web Addendum B.07.13.26.csvSHA-256 e50a1fa958ed2bb2…
- Medicare Coverage Database, current Billing and Coding Articles exportVersion MCD release 2026-09-24 · effective 2026-09-20 · file article.csvSHA-256 f31932f1df3b4035…
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.