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HCPCS J7524 · Level II · Part B drug

HCPCS J7524: Mycophenolate mofetil, oral, 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 J7524

Billing unit
5 MG
Mycophenol mofetil oral 5 mg
ASP payment limit
$0.002
October 2026
Practitioner MUE
none published
CMS publishes no MUE for this code
OPPS status
not in Addendum B
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J7524 is the Level II code for Mycophenolate mofetil, oral, 5 mg, billed per 5 MG. The Medicare Part B ASP payment limit for October 2026 is $0.002 per billing unit. 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 35 NDCs to it, sold as Cellcept, Mycophenolate Mofetil by Genentech, Inc., Teva Pharmaceuticals USA, Inc., Sandoz Inc.. No current Billing and Coding Article lists J7524, 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 J7524 at $0.002 per 5 MG for October 2026, derived from manufacturer average sales price plus 6%. Beneficiary coinsurance is 20%.

ASP payment limits for J7524
QuarterPayment limitPerCoinsurance
October 2026$0.0025 MG20%
July 2026n/a5 MG—
CMS note: Added October 2026

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 35 NDCs from 11 labelers to J7524. Report the NDC in the claim's drug segment and bill the number of J7524 units that equals the quantity administered divided by 5 MG; the last column gives units per full package.

NDCs that crosswalk to J7524
NDCDrug nameLabelerPackage sizeBilling units / package
00004-0259-01CellceptGenentech, Inc.100 × 15000
00004-0259-43CellceptGenentech, Inc.500 × 125000
00004-0260-01CellceptGenentech, Inc.100 × 110000
00004-0260-43CellceptGenentech, Inc.500 × 150000
00093-7334-01Mycophenolate MofetilTeva Pharmaceuticals USA, Inc.1 × 1005000
00093-7334-05Mycophenolate MofetilTeva Pharmaceuticals USA, Inc.1 × 50025000
00781-2067-01Mycophenolate MofetilSandoz Inc.1 × 1005000
00781-2067-05Mycophenolate MofetilSandoz Inc.1 × 50025000
00781-5175-01Mycophenolate MofetilSandoz Inc.1 × 10010000
00781-5175-05Mycophenolate MofetilSandoz Inc.1 × 50050000
00904-7078-61Mycophenolate MofetilMajor Pharmaceuticals100 × 110000
23155-0830-01Mycophenolate MofetilHeritage Pharmaceuticals Inc.100 × 15000
23155-0830-05Mycophenolate MofetilHeritage Pharmaceuticals Inc.500 × 125000
23155-0836-01Mycophenolate MofetilHeritage Pharmaceuticals Inc.100 × 110000
23155-0836-05Mycophenolate MofetilHeritage Pharmaceuticals Inc.500 × 150000
50090-4275-00Mycophenolate MofetilA-S Medication Solutions180 × 118000
50268-0557-15Mycophenolate MofetilAvPAK50 × 12500
50268-0558-15Mycophenolate MofetilAvPAK50 × 15000
59651-0624-01Mycophenolate MofetilAurobindo Pharma Usa, Inc.100 × 15000
59651-0624-05Mycophenolate MofetilAurobindo Pharma Usa, Inc.500 × 125000
59651-0638-01Mycophenolate MofetilAurobindo Pharma Usa, Inc.100 × 110000
60687-0438-01Mycophenolate MofetilAmerican Health Packaging1 × 10010000
60687-0885-01Mycophenolate MofetilAmerican Health Packaging100 × 15000
64380-0725-06Mycophenolate MofetilStrides Pharma Science Limited100 × 110000
64380-0725-07Mycophenolate MofetilStrides Pharma Science Limited1 × 50050000
64380-0726-06Mycophenolate MofetilStrides Pharma Science Limited100 × 15000
64380-0726-07Mycophenolate MofetilStrides Pharma Science Limited1 × 50025000
67877-0225-01Mycophenolate MofetilAscend Laboratories, LLC100 × 110000
67877-0225-05Mycophenolate MofetilAscend Laboratories, LLC500 × 150000
67877-0266-01Mycophenolate MofetilAscend Laboratories, LLC100 × 15000
67877-0266-05Mycophenolate MofetilAscend Laboratories, LLC500 × 125000
73190-0009-01Mycophenolate MofetilAvPAK100 × 15000
73190-0009-50Mycophenolate MofetilAvPAK500 × 125000
73190-0010-01Mycophenolate MofetilAvPAK100 × 110000
73190-0010-50Mycophenolate MofetilAvPAK500 × 150000

Medically Unlikely Edits (MUE)

CMS does not publish an MUE for J7524 in the 2026 Q4 tables. Some MUE values are confidential and applied without publication, so unit limits can still deny; document the dose and the units calculation on every claim.

NCCI edits and add-on relationships

No active practitioner PTP pair lists J7524 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.

J7524 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 J7524 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.

Common denials for J7524 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 J7524 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 J7524

What does HCPCS code J7524 describe?

J7524 is defined by CMS as "Mycophenolate mofetil, oral, 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 J7524 in October 2026?

The ASP-based payment limit is $0.002 per 5 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules.

Which NDCs map to J7524?

The October 2026 ASP crosswalk lists 35 NDCs from 11 labelers: Cellcept (Genentech, Inc.); Mycophenolate Mofetil (Teva Pharmaceuticals USA, Inc.); Mycophenolate Mofetil (Sandoz Inc.); Mycophenolate Mofetil (Major Pharmaceuticals). For example NDC 00004-0259-01 is a 100 package equal to 5000 billing units. The crosswalk's billing-units-per-package figure converts each package into J7524 units.

Does J7524 have NCCI bundling edits?

No active practitioner PTP pairs list J7524 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 2026-10-02. 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.