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HCPCS J7613 · Level II · Part B drug

HCPCS J7613: Albuterol, inhalation solution, fda-approved final product, non-compounded,

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 J7613

Billing unit
1 MG
Albuterol non-comp unit
ASP payment limit
$0.066
October 2026; +4.8% vs July 2026
Practitioner MUE
10
MAI 3
OPPS status
SI M
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J7613 is the Level II code for Albuterol, inhalation solution, fda-approved final product, non-compounded,, billed per 1 MG. The Medicare Part B ASP payment limit for October 2026 is $0.066 per billing unit, up 4.8% from July 2026. The practitioner MUE allows up to 10 units per date of service (MAI 3). Under OPPS it carries status indicator M. J7613 is billed in units of 1 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 36 NDCs to it, sold as Albuterol Sulfate by Mylan Pharmaceuticals Inc., Nephron SC, Inc., Actavis Pharma, Inc.. No current Billing and Coding Article lists J7613, 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 J7613 at $0.066 per 1 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.063 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J7613
QuarterPayment limitPerCoinsurance
October 2026$0.0661 MG20%
July 2026$0.0631 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 36 NDCs from 9 labelers to J7613. Report the NDC in the claim's drug segment and bill the number of J7613 units that equals the quantity administered divided by 1 MG; the last column gives units per full package.

NDCs that crosswalk to J7613
NDCDrug nameLabelerPackage sizeBilling units / package
00378-7057-52Albuterol SulfateMylan Pharmaceuticals Inc.3 × 2516
00378-7058-52Albuterol SulfateMylan Pharmaceuticals Inc.3 × 2532
00378-8270-52Albuterol SulfateMylan Pharmaceuticals Inc.3 × 2563
00378-8270-55Albuterol SulfateMylan Pharmaceuticals Inc.3 × 3075
00378-8270-91Albuterol SulfateMylan Pharmaceuticals Inc.3 × 60150
00378-8270-93Albuterol SulfateMylan Pharmaceuticals Inc.3 × 3075
00487-0301-01Albuterol SulfateNephron SC, Inc.3 × 3019
00487-9501-01Albuterol SulfateNephron SC, Inc.3 × 3075
00487-9501-03Albuterol SulfateNephron SC, Inc.3 × 3075
00487-9501-25Albuterol SulfateNephron SC, Inc.3 × 2563
00487-9501-60Albuterol SulfateNephron SC, Inc.3 × 60150
00487-9904-01Albuterol SulfateNephron SC, Inc.3 × 3038
00487-9904-25Albuterol SulfateNephron SC, Inc.3 × 2532
00591-3467-53Albuterol SulfateActavis Pharma, Inc.3 × 2516
00591-3468-53Albuterol SulfateActavis Pharma, Inc.3 × 2532
47335-0703-49Albuterol SulfateSun Pharmaceutical Global FZE.3 × 2563
47335-0703-52Albuterol SulfateSun Pharmaceutical Global FZE.3 × 3075
47335-0703-54Albuterol SulfateSun Pharmaceutical Global FZE.3 × 60150
50090-0516-00Albuterol SulfateA-S Medication Solutions3 × 2563
50090-0516-01Albuterol SulfateA-S Medication Solutions3 × 125313
50090-6560-00Albuterol SulfateA-S Medication Solutions3 × 2563
50090-6560-01Albuterol SulfateA-S Medication Solutions3 × 75188
50742-0392-25Albuterol SulfateIngenus Pharmaceuticals LLC3 × 2516
50742-0393-25Albuterol SulfateIngenus Pharmaceuticals LLC3 × 2532
60687-0395-83Albuterol SulfateAmerican Health Packaging3 × 3075
62135-0826-84Albuterol SulfateChartwell3 × 3019
62135-0827-84Albuterol SulfateChartwell3 × 3038
62135-0828-84Albuterol SulfateChartwell3 × 3075
76204-0010-01Albuterol SulfateRitedose Pharmaceuticals, LLC3 × 3019
76204-0010-55Albuterol SulfateRitedose Pharmaceuticals, LLC3 × 2516
76204-0011-01Albuterol SulfateRitedose Pharmaceuticals, LLC3 × 3038
76204-0011-55Albuterol SulfateRitedose Pharmaceuticals, LLC3 × 2532
76204-0200-01Albuterol SulfateRitedose Pharmaceuticals, LLC3 × 3075
76204-0200-25Albuterol SulfateRitedose Pharmaceuticals, LLC3 × 2563
76204-0200-30Albuterol SulfateRitedose Pharmaceuticals, LLC3 × 3075
76204-0200-60Albuterol SulfateRitedose Pharmaceuticals, LLC3 × 60150

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J7613. For practitioners the limit is 10 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 J7613 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services103 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital03 Date of Service Edit: ClinicalCMS Policy
DME supplier13953 Date of Service Edit: ClinicalPublished Contractor Policy

NCCI edits and add-on relationships

No active practitioner PTP pair lists J7613 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.

J7613 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 J7613 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, J7613 carries status indicator M. Consult the OPPS status indicator table for payment treatment.

Common denials for J7613 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 J7613 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 J7613

What does HCPCS code J7613 describe?

J7613 is defined by CMS as "Albuterol, inhalation solution, fda-approved final product, non-compounded,". 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 J7613 in October 2026?

The ASP-based payment limit is $0.066 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 $0.063.

How many units of J7613 can be billed per day?

The practitioner Medically Unlikely Edit is 10 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 J7613?

The October 2026 ASP crosswalk lists 36 NDCs from 9 labelers: Albuterol Sulfate (Mylan Pharmaceuticals Inc.); Albuterol Sulfate (Nephron SC, Inc.); Albuterol Sulfate (Actavis Pharma, Inc.); Albuterol Sulfate (Sun Pharmaceutical Global FZE.). For example NDC 00378-7057-52 is a 3 package equal to 16 billing units. The crosswalk's billing-units-per-package figure converts each package into J7613 units.

Does J7613 have NCCI bundling edits?

No active practitioner PTP pairs list J7613 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.