J7402 HCPCS code: Mometasone furoate sinus implant, (sinuva), 10 micrograms
J7402 is the HCPCS Level II code for mometasone furoate sinus implant, (sinuva), 10 micrograms. In 2024 Medicare paid an average of $8.88 per service for J7402 across 13,504 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 270 per day on outpatient hospital claims. Medicare volume fell 73% from 2022 to 2024 (50,881 to 13,504 services). In 2024, about 42 clinicians billed Medicare for J7402 for 56 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2021-04-01 |
| Last action effective | 2021-04-01 |
Who bills J7402 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 42 |
| Medicare beneficiaries | 56 |
| States with claims | 0 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7402, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 50,881 | 204 | $10.50 | $8.37 |
| 2023 | 23,256 | 95 | $10.95 | $8.71 |
| 2024 | 13,504 | 56 | $11.15 | $8.88 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 270 | Prescribing Information |
| practitioner claims | 270 | Prescribing Information |
What changed for J7402
- 2021-04-01: J7402 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 J7402?
J7402 is the HCPCS Level II code for mometasone furoate sinus implant, (sinuva), 10 micrograms. Short descriptor: "Mometasone sinus sinuva".
How much does Medicare pay for J7402?
In 2024, the average Medicare payment was $8.88 per service (average allowed $11.15).
Does Medicare cover J7402?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J7402 can be billed per day?
270 on outpatient hospital claims; 270 on practitioner claims (NCCI medically unlikely edits).
Related J74 codes
- J7401 — Mometasone furoate sinus implant, 10 micrograms
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 J7402
- Watch J7402 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7402
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.