J7040 HCPCS code: Infusion, normal saline solution, sterile (500 ml = 1 unit)
J7040 is the HCPCS Level II code for infusion, normal saline solution, sterile (500 ml = 1 unit). In 2024 Medicare paid an average of $1.00 per service for J7040 across 201,686 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 12 per day on outpatient hospital claims. Medicare volume rose 3% from 2022 to 2024 (195,939 to 201,686 services). In 2024, about 8,624 clinicians billed Medicare for J7040 for 55,721 beneficiaries; California, New York, Florida accounted for 44% of services.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 1984-01-01 |
| Last action effective | 1997-01-01 |
Who bills J7040 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 8,624 |
| Medicare beneficiaries | 55,721 |
| States with claims | 54 |
| Share of services in top 3 states (California, New York, Florida) | 44% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7040, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 195,939 | 54,468 | $1.30 | $1.02 |
| 2023 | 207,690 | 55,497 | $1.25 | $0.98 |
| 2024 | 201,686 | 55,721 | $1.28 | $1.00 |
States with the most J7040 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 48,923 | $0.98 |
| New York | 20,196 | $1.00 |
| Florida | 20,019 | $1.02 |
| Texas | 12,718 | $1.01 |
| South Carolina | 12,421 | $1.02 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 12 | Clinical: Data |
| practitioner claims | 6 | Clinical: Data |
Medicare policy articles for this code
- A57114: Billing and Coding: Trigger Point Injections (First Coast Service Options, Inc. (MAC - Part B))
- A57751: Billing and Coding: Trigger Point Injections (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
Covered diagnoses (2 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| M79.12 | Myalgia of auxiliary muscles, head and neck | 2 |
| M79.18 | Myalgia, other site | 2 |
What changed for J7040
- 1984-01-01: J7040 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J7040?
J7040 is the HCPCS Level II code for infusion, normal saline solution, sterile (500 ml = 1 unit). Short descriptor: "Normal saline solution infus".
How much does Medicare pay for J7040?
In 2024, the average Medicare payment was $1.00 per service (average allowed $1.28).
Does Medicare cover J7040?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J7040?
Medicare policy articles that cite J7040 list 2 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include M79.12 (Myalgia of auxiliary muscles, head and neck), M79.18 (Myalgia, other site). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J7040 can be billed per day?
12 on outpatient hospital claims; 6 on practitioner claims (NCCI medically unlikely edits).
Related J70 codes
- J7030 — Infusion, normal saline solution , 1000 cc
- J7042 — 5% dextrose/normal saline (500 ml = 1 unit)
- J7050 — Infusion, normal saline solution, 250 cc
- J7060 — 5% dextrose/water (500 ml = 1 unit)
- J7070 — Infusion, d5w, 1000 cc
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J7040
- Watch J7040 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7040
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.