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HCPCS J7502 · Level II · Part B drug

HCPCS J7502: Cyclosporine, oral, 100 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 J7502

Billing unit
100 MG
Cyclosporine oral 100 mg
ASP payment limit
$1.455
October 2026; -6.7% vs July 2026
Practitioner MUE
0
MAI 3
OPPS status
SI N
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J7502 is the Level II code for Cyclosporine, oral, 100 mg, billed per 100 MG. The Medicare Part B ASP payment limit for October 2026 is $1.455 per billing unit, down 6.7% from July 2026. The practitioner MUE allows up to 0 units per date of service (MAI 3). Under OPPS it carries status indicator N. Oral drugs under Part B are payable only in the specific statutory categories (for example oral anticancer or antiemetic drugs with a self-administration exception), so the diagnosis and the regimen must match that category. The ASP crosswalk maps 14 NDCs to it, sold as Gengraf, Sandimmune, Neoral by AbbVie Inc., Novartis Pharmaceuticals Corporation, Teva Pharmaceuticals USA, Inc.. No current Billing and Coding Article lists J7502, 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 J7502 at $1.455 per 100 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $1.559 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J7502
QuarterPayment limitPerCoinsurance
October 2026$1.455100 MG20%
July 2026$1.559100 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 14 NDCs from 7 labelers to J7502. Report the NDC in the claim's drug segment and bill the number of J7502 units that equals the quantity administered divided by 100 MG; the last column gives units per full package.

NDCs that crosswalk to J7502
NDCDrug nameLabelerPackage sizeBilling units / package
00074-3109-32GengrafAbbVie Inc.30 × 130
00074-7269-50GengrafAbbVie Inc.50 × 150
00078-0110-22SandimmuneNovartis Pharmaceuticals Corporation50 × 150
00078-0241-15SandimmuneNovartis Pharmaceuticals Corporation30 × 130
00078-0248-15NeoralNovartis Pharmaceuticals Corporation30 × 130
00078-0274-22NeoralNovartis Pharmaceuticals Corporation50 × 150
00093-9018-65CyclosporineTeva Pharmaceuticals USA, Inc.30 × 18
00093-9019-65CyclosporineTeva Pharmaceuticals USA, Inc.30 × 115
00093-9020-65CyclosporineTeva Pharmaceuticals USA, Inc.30 × 130
00172-7313-20CyclosporineIvax Pharmaceuticals, Inc.50 × 150
23155-0839-30CyclosporineHeritage Pharmaceuticals Inc.30 × 130
60505-0134-00CyclosporineApotex Corp30 × 130
60505-4632-03CyclosporineApotex Corp30 × 130
68084-0921-25CyclosporineAmerican Health Packaging30 × 130

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J7502. For practitioners the limit is 0 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 J7502 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalOral Medication; Not Payable
Facility outpatient hospital603 Date of Service Edit: ClinicalClinical: Data
DME supplier7203 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J7502 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.

J7502 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 J7502 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, J7502 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J7502 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 J7502 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 J7502

What does HCPCS code J7502 describe?

J7502 is defined by CMS as "Cyclosporine, oral, 100 mg". Each billing unit represents 100 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J7502 in October 2026?

The ASP-based payment limit is $1.455 per 100 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $1.559.

How many units of J7502 can be billed per day?

The practitioner Medically Unlikely Edit is 0 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 "Oral Medication; Not Payable" as the rationale.

Which NDCs map to J7502?

The October 2026 ASP crosswalk lists 14 NDCs from 7 labelers: Gengraf (AbbVie Inc.); Sandimmune (Novartis Pharmaceuticals Corporation); Neoral (Novartis Pharmaceuticals Corporation); Cyclosporine (Teva Pharmaceuticals USA, Inc.). For example NDC 00074-3109-32 is a 30 package equal to 30 billing units. The crosswalk's billing-units-per-package figure converts each package into J7502 units.

Does J7502 have NCCI bundling edits?

No active practitioner PTP pairs list J7502 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.