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HCPCS J7799 · Level II · J code

J7799: NOC drugs, other than inhalation drugs, administered through DME, HCPCS Level II J code

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: HCPCS Level II file: October 2026 (effective October 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); NCCI MUE tables: 2026 Q4 (effective October 1, 2026); NCCI PTP edits: v323r0 (2026 Q4) (effective October 1, 2026); OPPS Addendum B: October 2026 (effective October 1, 2026); Medicare Coverage Database LCD export: MCD release October 8, 2026 (effective October 4, 2026). Next CMS release: January 1, 2027 (quarterly update) for the HCPCS Level II file and NCCI MUE tables and NCCI PTP edits and OPPS Addendum B; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file; weekly, every Thursday for the Medicare Coverage Database LCD export.

Key facts for J7799

Medicare payment
no PFS amount
PFS status E
Coverage code
D
special coverage instructions apply
Practitioner MUE
2
MAI 3
OPPS status
SI N
Items and Services packaged into APC rates
NCCI PTP pairs
0
practitioner file
LCDs and articles
1 / 0

TL;DR

J7799 is a Level II code from the J section (drugs administered other than oral method and chemotherapy drugs), in use since 1993: "Noc drugs, other than inhalation drugs, administered through dme". The physician fee schedule lists J7799 with status E (excluded from the physician fee schedule by regulation), so the PFS carries no national amount for it. MUE limits for J7799: practitioner 2 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 2 (MAI 3, Clinical: CMS Workgroup). 1 active LCD lists J7799: L33794 (External Infusion Pumps). OPPS status indicator N: Items and Services packaged into APC rates. HCPCS record: BETOS D1G (drugs administered through DME); pricing indicator 51; type of service 1 (medical care), P (lump-sum purchase of DME, prosthetics or orthotics). 1 other active code opens with "Noc drugs"; related codes: J7699, J7999, J7298, J7297.

J7799 descriptor and code status

The October 2026 HCPCS Level II file describes J7799 as “Noc drugs, other than inhalation drugs, administered through dme”. It sits in the J section (drugs administered other than oral method and chemotherapy drugs), listed with the other J codes without an ASP payment limit. Although searches often call it the "J7799 CPT code", J7799 is a HCPCS Level II code maintained by CMS, not an AMA CPT code; both go in the same procedure-code field on the claim.

HCPCS file attributes of J7799
FieldValue
Short descriptorNon-inhalation drug for dme
Added to HCPCS1993-01-01
Last actionN (no maintenance), effective 2002-07-01
Coverage codeD: special coverage instructions apply
Pricing indicator51: drugs
BETOS categoryD1G: drugs administered through DME
Type of service1: medical care; P: lump-sum purchase of DME, prosthetics or orthotics

Medicare payment for J7799

The physician fee schedule lists J7799 with status E (excluded from the physician fee schedule by regulation), so the PFS carries no national amount for it. The amounts below are national figures from the October 2026 CMS files; the contractor applies the locality, rural or state adjustment and the beneficiary's cost sharing.

Physician fee schedule (RVU26D)

Status E: excluded from the physician fee schedule by regulation. Global period XXX (global surgery concept does not apply); PC/TC indicator 9 (professional/technical concept does not apply).

Hospital outpatient (OPPS Addendum B)

Status indicator N (Items and Services packaged into APC rates), with no separate OPPS payment rate.

Ambulatory surgical center (Addendum BB)

Payment indicator N1 (Packaged service/item; no separate payment made).

Medically Unlikely Edits for J7799

MUE limits for J7799: practitioner 2 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 2 (MAI 3, Clinical: CMS Workgroup). The practitioner MUE is a date-of-service clinical edit: units above the limit deny but can be paid on appeal with documentation.

MUE values for J7799 by setting
SettingMUE (units/DOS)MAICMS rationale
Practitioner services23 Date of Service Edit: ClinicalClinical: CMS Workgroup
Facility outpatient hospital23 Date of Service Edit: ClinicalClinical: CMS Workgroup

The MUE lookup for J7799 shows every setting next to any other code on the same claim.

NCCI edits and add-on rules

No active practitioner PTP pair lists J7799 in v323r0.

J7799 is neither an add-on code nor a designated primary code in the 2026 Q4 NCCI add-on edit file.

Pair counts show exposure, not the answer for one claim. Check J7799 against a second code to see whether the pair bundles and whether a modifier can separate the services.

Medicare coverage policies for J7799

1 active Local Coverage Determination and 0 billing and coding articles list J7799. Each applies only in its contractor's jurisdiction, and the article carries the diagnosis codes that support the item or service.

Denials to expect on J7799

CARC 50 · N115

the diagnosis or documentation does not meet the LCD or billing article that lists J7799

CARC 151 · N362

units of J7799 exceed the practitioner MUE of 2 per date of service

CARC 4

the modifier reported is inconsistent with the code

CARC 16

the claim lacks the description, invoice or pricing detail a contractor-priced code needs

Where QuickIntell fits for J7799 claims

QuickCode supports qualified coder review of units, modifiers and NCCI pairs for J7799 before the claim leaves, and QuickRCM carries claim readiness and the denial follow-up when an edit or coverage policy is missed.

See QuickCode for coder reviewSee QuickRCM for denial follow-upBook a meeting

Frequently asked questions: HCPCS J7799

What does HCPCS code J7799 describe?

"Noc drugs, other than inhalation drugs, administered through dme" (short descriptor "Non-inhalation drug for dme"), in the J section (drugs administered other than oral method and chemotherapy drugs). Added 1993-01-01; last action N (no maintenance) effective 2002-07-01.

Is J7799 a CPT code?

No: CMS maintains J7799 in HCPCS Level II, while the AMA maintains CPT. People do search "J7799 CPT code", and it goes in the same procedure-code field.

What does Medicare pay for J7799?

The physician fee schedule lists J7799 with status E (excluded from the physician fee schedule by regulation), so the PFS carries no national amount for it.

How many units of J7799 can be billed per day?

MUE limits for J7799: practitioner 2 (MAI 3, Clinical: CMS Workgroup); hospital outpatient 2 (MAI 3, Clinical: CMS Workgroup). For the practitioner MUE (MAI 3), units above 2 deny for the day but can be paid on appeal with documentation; denials arrive as CARC 151.

Does Medicare cover J7799?

Coverage code D (special coverage instructions apply). 1 active LCD lists J7799: L33794 (External Infusion Pumps).

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

This page is an operational reference compiled from CMS publications: the HCPCS Level II file, the physician, DMEPOS and clinical laboratory fee schedules, OPPS and ASC addenda, NCCI MUE, PTP and add-on edit tables and the Medicare Coverage Database. Amounts are Medicare national figures before locality and state adjustment; Medicaid and commercial payers set their own. CPT codes are shown as numbers only; CPT descriptors are copyright AMA. Nothing here is legal, clinical or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.