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HCPCS J7620 · Level II · Part B drug

HCPCS J7620: Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved

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 J7620

Billing unit
2.5 MG/0.5 MG
Albuterol ipratrop non-comp
ASP payment limit
$0.197
October 2026; -2.0% vs July 2026
Practitioner MUE
6
MAI 3
OPPS status
SI M
NCCI exposure
no PTP pairs
Coverage articles
0
none list this code

TL;DR

HCPCS J7620 is the Level II code for Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved, billed per 2.5 MG/0.5 MG. The Medicare Part B ASP payment limit for October 2026 is $0.197 per billing unit, down 2.0% from July 2026. The practitioner MUE allows up to 6 units per date of service (MAI 3). Under OPPS it carries status indicator M. J7620 is billed in units of 2.5 MG/0.5 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 27 NDCs to it, sold as Albuterol ipratropium, Albuterol Ipratropium by Mylan Pharmaceuticals Inc., Nephron SC, Inc., Sun Pharmaceutical Global FZE.. No current Billing and Coding Article lists J7620, 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 J7620 at $0.197 per 2.5 MG/0.5 MG for October 2026, derived from manufacturer average sales price plus 6%, compared with $0.201 in July 2026. Beneficiary coinsurance is 20%.

ASP payment limits for J7620
QuarterPayment limitPerCoinsurance
October 2026$0.1972.5 MG/0.5 MG20%
July 2026$0.2012.5 MG/0.5 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 27 NDCs from 10 labelers to J7620. Report the NDC in the claim's drug segment and bill the number of J7620 units that equals the quantity administered divided by 2.5 MG/0.5 MG; the last column gives units per full package.

NDCs that crosswalk to J7620
NDCDrug nameLabelerPackage sizeBilling units / package
00378-9671-30Albuterol ipratropiumMylan Pharmaceuticals Inc.3 × 3030
00378-9671-60Albuterol ipratropiumMylan Pharmaceuticals Inc.3 × 6060
00378-9671-93Albuterol ipratropiumMylan Pharmaceuticals Inc.3 × 3030
00487-0201-01Albuterol ipratropiumNephron SC, Inc.3 × 3030
00487-0201-02Albuterol ipratropiumNephron SC, Inc.3 × 3030
00487-0201-03Albuterol ipratropiumNephron SC, Inc.3 × 3030
00487-0201-60Albuterol ipratropiumNephron SC, Inc.3 × 6060
47335-0756-49Albuterol IpratropiumSun Pharmaceutical Global FZE.3 × 3030
47335-0756-52Albuterol ipratropiumSun Pharmaceutical Global FZE.3 × 6060
50090-1382-00Albuterol ipratropiumA-S Medication Solutions3 × 3030
50090-1669-00Albuterol ipratropiumA-S Medication Solutions3 × 3030
50090-6288-00Albuterol ipratropiumA-S Medication Solutions3 × 3030
60687-0405-83Albuterol ipratropiumAmerican Health Packaging3 × 3030
62135-0831-84Albuterol ipratropiumChartwell3 × 3030
64980-0645-03Albuterol IpratropiumRising Pharma Holdings, Inc.3 × 3030
64980-0645-06Albuterol IpratropiumRising Pharma Holdings, Inc.3 × 6060
68788-8103-03Albuterol ipratropiumPreferred Pharmaceuticals Inc3 × 3030
69097-0173-53Albuterol ipratropiumCipla USA, Inc.3 × 3030
69097-0173-64Albuterol ipratropiumCipla USA, Inc.3 × 6060
69097-0840-53Albuterol ipratropiumCipla USA, Inc.3 × 3030
69097-0840-64Albuterol ipratropiumCipla USA, Inc.3 × 6060
69097-0840-87Albuterol ipratropiumCipla USA, Inc.3 × 3030
76204-0600-01Albuterol ipratropiumRitedose Pharmaceuticals, LLC3 × 3030
76204-0600-05Albuterol ipratropiumRitedose Pharmaceuticals, LLC3 × 3030
76204-0600-12Albuterol ipratropiumRitedose Pharmaceuticals, LLC3 × 6060
76204-0600-30Albuterol ipratropiumRitedose Pharmaceuticals, LLC3 × 3030
76204-0600-60Albuterol ipratropiumRitedose Pharmaceuticals, LLC3 × 6060

Medically Unlikely Edits (MUE)

CMS publishes 3 MUE values for J7620. For practitioners the limit is 6 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 J7620 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services63 Date of Service Edit: ClinicalPrescribing Information
Facility outpatient hospital03 Date of Service Edit: ClinicalCMS Policy
DME supplier5583 Date of Service Edit: ClinicalPrescribing Information

NCCI edits and add-on relationships

No active practitioner PTP pair lists J7620 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.

J7620 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 J7620 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, J7620 carries status indicator M. Consult the OPPS status indicator table for payment treatment.

Common denials for J7620 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 J7620 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 J7620

What does HCPCS code J7620 describe?

J7620 is defined by CMS as "Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved". Each billing unit represents 2.5 MG/0.5 MG, so the units reported on the claim must equal the dose administered divided by that unit.

What is the Medicare reimbursement for J7620 in October 2026?

The ASP-based payment limit is $0.197 per 2.5 MG/0.5 MG, with 20% beneficiary coinsurance. Medicare Administrative Contractors apply this limit; commercial payers use their own fee schedules. The July 2026 limit was $0.201.

How many units of J7620 can be billed per day?

The practitioner Medically Unlikely Edit is 6 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 J7620?

The October 2026 ASP crosswalk lists 27 NDCs from 10 labelers: Albuterol ipratropium (Mylan Pharmaceuticals Inc.); Albuterol ipratropium (Nephron SC, Inc.); Albuterol Ipratropium (Sun Pharmaceutical Global FZE.); Albuterol ipratropium (Sun Pharmaceutical Global FZE.). For example NDC 00378-9671-30 is a 3 package equal to 30 billing units. The crosswalk's billing-units-per-package figure converts each package into J7620 units.

Does J7620 have NCCI bundling edits?

No active practitioner PTP pairs list J7620 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.