J7516 HCPCS code: Injection, cyclosporine, 250 mg
J7516 is the HCPCS Level II code for injection, cyclosporine, 250 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 4 per day on outpatient hospital claims.
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 | 2000-01-01 |
| Last action effective | 2024-04-01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 4 | Prescribing Information |
| practitioner claims | 1 | Clinical: Data |
What changed for J7516
- 2000-01-01: J7516 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 J7516?
J7516 is the HCPCS Level II code for injection, cyclosporine, 250 mg. Short descriptor: "Inj, cyclosporine 250mg".
Does Medicare cover J7516?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J7516 can be billed per day?
4 on outpatient hospital claims; 1 on practitioner claims (NCCI medically unlikely edits).
Related J75 codes
- J7500 — Azathioprine, oral, 50 mg
- J7501 — Azathioprine, parenteral, 100 mg
- J7502 — Cyclosporine, oral, 100 mg
- J7503 — Tacrolimus, extended release, (envarsus xr), oral, 0.25 mg
- J7504 — Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg
- J7505 — Muromonab-cd3, parenteral, 5 mg
- J7506 — Prednisone, oral, per 5 mg
- J7507 — Tacrolimus, immediate release, oral, 1 mg
- J7508 — Tacrolimus, extended release, (astagraf xl), oral, 0.1 mg
- J7509 — Methylprednisolone oral, per 4 mg
- J7510 — Prednisolone oral, per 5 mg
- J7511 — Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg
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Next steps
- Run a reimbursement report for a device billed under J7516
- Watch J7516 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7516
Sources: CMS HCPCS Level II release October 2026; 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.