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HCPCS J7518 · Level II · Part B drug

HCPCS J7518: Mycophenolic acid, oral, 180 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 J7518

Billing unit
180 MG
Mycophenolic acid
ASP payment limit
$0.257
October 2026; -20.9% 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 J7518 is the Level II code for Mycophenolic acid, oral, 180 mg, billed per 180 MG. The Medicare Part B ASP payment limit for October 2026 is $0.257 per billing unit, down 20.9% 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 29 NDCs to it, sold as Myfortic DR, Mycophenolic Acid DR, Mycophenolic Acid by Novartis Pharmaceuticals Corporation, Major Pharmaceuticals, Accord healthcare Inc. No current Billing and Coding Article lists J7518, 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 J7518 at $0.257 per 180 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.325 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J7518
QuarterPayment limitPerCoinsurance
October 2026$0.257180 MG20%
July 2026$0.325180 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 29 NDCs from 13 labelers to J7518. Report the NDC in the claim's drug segment and bill the number of J7518 units that equals the quantity administered divided by 180 MG; the last column gives units per full package.

NDCs that crosswalk to J7518
NDCDrug nameLabelerPackage sizeBilling units / package
00078-0385-66Myfortic DRNovartis Pharmaceuticals Corporation120 × 1120
00078-0386-66Myfortic DRNovartis Pharmaceuticals Corporation120 × 1240
00904-6785-04Mycophenolic Acid DRMajor Pharmaceuticals30 × 130
00904-6785-61Mycophenolic Acid DRMajor Pharmaceuticals100 × 1100
00904-6786-04Mycophenolic Acid DRMajor Pharmaceuticals30 × 160
00904-6786-61Mycophenolic Acid DRMajor Pharmaceuticals100 × 1200
16729-0261-29Mycophenolic Acid DRAccord healthcare Inc120 × 1120
24979-0160-44Mycophenolic Acid DRTWI Pharmaceuticals, Inc.120 × 1120
24979-0161-44Mycophenolic Acid DRTWI Pharmaceuticals, Inc.120 × 1240
50090-6492-00Mycophenolic Acid DRA-S Medication Solutions180 × 1360
50268-0559-12Mycophenolic Acid DRAvPAK20 × 120
59651-0621-08Mycophenolic Acid DRAurobindo Pharma Usa, Inc.120 × 1120
59651-0622-08Mycophenolic Acid DRAurobindo Pharma Usa, Inc.120 × 1240
60505-2965-07Mycophenolic Acid DRApotex Corp120 × 1120
60505-2966-07Mycophenolic Acid DRApotex Corp120 × 1240
67877-0426-12Mycophenolic Acid DRAscend Laboratories, LLC120 × 1120
67877-0427-12Mycophenolic Acid DRAscend Laboratories, LLC120 × 1240
67877-0928-12Mycophenolic AcidAscend Laboratories, LLC120 × 1120
67877-0929-12Mycophenolic AcidAscend Laboratories, LLC120 × 1240
68084-0907-21Mycophenolic Acid DRAmerican Health Packaging30 × 130
68084-0918-25Mycophenolic Acid DRAmerican Health Packaging30 × 160
70377-0039-11Mycophenolic Acid DRBiocon Pharma Inc120 × 1120
70377-0040-11Mycophenolic Acid DRBiocon Pharma Inc120 × 1240
70377-0126-11Mycophenolic Acid DRBiocon Pharma Inc120 × 1120
70377-0127-11Mycophenolic Acid DRBiocon Pharma Inc120 × 1240
70436-0172-23Mycophenolic Acid DRSlate Run Pharmaceuticals120 × 1120
70436-0173-23Mycophenolic Acid DRSlate Run Pharmaceuticals120 × 1240
72819-0155-08Mycophenolic Acid DRArchis Pharma LLC120 × 1120
72819-0156-08Mycophenolic Acid DRArchis Pharma LLC120 × 1240

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J7518. 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 J7518 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services03 Date of Service Edit: ClinicalCMS Policy
Facility outpatient hospital123 Date of Service Edit: ClinicalClinical: Society Comment
DME supplier7203 Date of Service Edit: ClinicalCMS Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J7518 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.

J7518 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 J7518 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, J7518 carries status indicator N. Status N means payment is packaged into the associated procedure and no separate OPPS payment is made.

Common denials for J7518 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 J7518 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 J7518

What does HCPCS code J7518 describe?

J7518 is defined by CMS as "Mycophenolic acid, oral, 180 mg". Each billing unit represents 180 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J7518 in October 2026?

The ASP-based payment limit is $0.257 per 180 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.325.

How many units of J7518 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 "CMS Policy" as the rationale.

Which NDCs map to J7518?

The October 2026 ASP crosswalk lists 29 NDCs from 13 labelers: Myfortic DR (Novartis Pharmaceuticals Corporation); Mycophenolic Acid DR (Major Pharmaceuticals); Mycophenolic Acid DR (Accord healthcare Inc); Mycophenolic Acid DR (TWI Pharmaceuticals, Inc.). For example NDC 00078-0385-66 is a 120 package equal to 120 billing units. The crosswalk's billing-units-per-package figure converts each package into J7518 units.

Does J7518 have NCCI bundling edits?

No active practitioner PTP pairs list J7518 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.