Skip to main content
HCPCS J7526 · Level II · Part B drug

HCPCS J7526: Injection, mycophenolate mofetil, 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 J7526

Billing unit
5 MG
Inj mycophenola mofetil 5 mg
ASP payment limit
$0.20
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 J7526 is the Level II code for Injection, mycophenolate mofetil, 5 mg, billed per 5 MG. The Medicare Part B ASP payment limit for October 2026 is $0.20 per billing unit. J7526 is billed in units of 5 MG; 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 6 NDCs to it, sold as Cellcept IV, Mycophenolate Mofetil IV by Genentech, Inc., Endo USA, Inc., Mylan Institutional LLC. No current Billing and Coding Article lists J7526, 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 J7526 at $0.20 per 5 MG for October 2026, derived from manufacturer average sales price plus 6%. Beneficiary coinsurance is 20%.

ASP payment limits for J7526
QuarterPayment limitPerCoinsurance
October 2026$0.205 MG20%
July 2026n/a5 MG—
CMS note: Added October 2026

NDC to HCPCS billing-unit conversion

The October 2026 ASP crosswalk maps 6 NDCs from 5 labelers to J7526. Report the NDC in the claim's drug segment and bill the number of J7526 units that equals the quantity administered divided by 5 MG; the last column gives units per full package.

NDCs that crosswalk to J7526
NDCDrug nameLabelerPackage sizeBilling units / package
00004-0298-09Cellcept IVGenentech, Inc.1 × 4400
42023-0172-04Mycophenolate Mofetil IVEndo USA, Inc.1 × 4400
67457-0386-81Mycophenolate Mofetil IVMylan Institutional LLC1 × 4400
71288-0803-21Mycophenolate Mofetil IVMeitheal Pharmaceuticals Inc.1 × 4400
71288-0803-92Mycophenolate Mofetil IVMeitheal Pharmaceuticals Inc.1 × 4400
72485-0415-04Mycophenolate Mofetil IVArmas Pharmaceuticals Inc.1 × 4400

Medically Unlikely Edits (MUE)

CMS does not publish an MUE for J7526 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 J7526 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.

J7526 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 J7526 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 J7526 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 J7526 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 meeting

Frequently asked questions — HCPCS J7526

What does HCPCS code J7526 describe?

J7526 is defined by CMS as "Injection, mycophenolate mofetil, 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 J7526 in October 2026?

The ASP-based payment limit is $0.20 per 5 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules.

Which NDCs map to J7526?

The October 2026 ASP crosswalk lists 6 NDCs from 5 labelers: Cellcept IV (Genentech, Inc.); Mycophenolate Mofetil IV (Endo USA, Inc.); Mycophenolate Mofetil IV (Mylan Institutional LLC); Mycophenolate Mofetil IV (Meitheal Pharmaceuticals Inc.). For example NDC 00004-0298-09 is a 1 package equal to 400 billing units. The crosswalk's billing-units-per-package figure converts each package into J7526 units.

Does J7526 have NCCI bundling edits?

No active practitioner PTP pairs list J7526 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.