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J7402

J7402 – Mometasone furoate sinus implant, (sinuva), 10 micrograms · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 1 NDC crosswalked per 10 MCG $11.345/unit ASP+6%

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Compiled from public FDA, CMS, DailyMed, NADAC, and related drug data sources. Editorial policy

📋 J7402 summary

J7402 is a HCPCS Level II J-code used to bill Mometasone furoate sinus implant, (sinuva), 10 micrograms, billed per 10 MCG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.

Brand names associated with J7402: Sinuva

Code J7402 Billing unit 10 MCG Payment limit $11.345/unit NDC-Crosswalk 1 Quarter Q3 2026 RxCUI Atlas Trace the drug concept →

⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.

🗂️ Key billing facts

HCPCS codeJ7402
DescriptorMometasone furoate sinus implant, (sinuva), 10 micrograms
Billing unit10 MCG
Payment limit / unit$11.345
Est. ASP / unit$10.703 est.
Mapped NDCs1
Data periodQ3 2026
Last updated2026-08-20

🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026

📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$11.345
Est. ASP / unit
$10.703 est.
Est. after 2% sequester
$11.118
HCPCS dosage
10 MCG
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionMometasone furoate sinus implant, (sinuva), 10 micrograms
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment groupYY
Action codeN — No maintenance this year
Effective date2021-04-01
Date added2021-04-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J7402 = 10 mcg. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.

🔁 NDCs that bill under J7402 WITH EST. MEDICARE PAY

1 NDC map to J7402. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($11.345/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
10599-0003-01 Sinuva mometasone furoate 1350 ug/1 IMPLANT Intersect 1 POUCH in 1 CARTON (10599-003-01) / 1 IM... 1350 ug/1 135 $1,531.58 — ● Active CMS ASP
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.

📊 Medicare utilization & spend CMS · PART B · 2025 (Q1-Q4)

Total Part B spend
$118.6K
Claims
48
Beneficiaries
41
Spend / beneficiary
$2,892.31
Spend / claim
$2,470.52
Where J7402 ranks among Part B drugs · 2025 (Q1-Q4) · neighbors ±5
Total spending — #681 of 918
#676 ARRANON* J9261 $130.3K #677 GLYCOPYRROLATE(J1596... J1596 $128.4K #678 LINCOCIN* J2010 $125.5K #679 CYTAL, PER SQUARE CE... Q4166 $120.2K #680 MICAFUNGIN(J2248)* J2248 $119.6K #681 SINUVA J7402 $118.6K #682 KEPIVANCE J2425 $114.1K #683 FAMOTIDINE J1308 $112.6K #684 METHOTREXATE SODIUM* J9260 $111.6K #685 VINCASAR PFS* J9370 $111.3K #686 PROGENAMATRIX, PER S... Q4222 $110.1K
Total claims — #853 of 918
#848 FLUPHENAZINE HCL J2679 50 #849 ARRANON* J9261 49 #850 EPINEPHRINE J0166 48 #851 ERAXIS J0348 48 #852 DROPERIDOL J1790 48 #853 SINUVA J7402 48 #854 AMNIOARMOR 1 SQ CM** Q4188 47 #855 NALOXONE HCL(J2310) J2310 44 #856 WINRHO SDF J2792 44 #857 AXOLOTL GRAFT, PER S... Q4331 43 #858 DOXERCALCIFEROL* J1270 42

Full breakdown by period (1)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2025 (Q1-Q4) $118.6K 41 48 $2,892.31 $2,470.52
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.

📈 Medicare Part B claims detail CMS PSPS · 2024

Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$122K
Medicare paid
$95.7K
Submitted services
11,333
Denial rate
4.8%
Allowed / service
$11.30
Submitted charges
$346.6K
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.

🗃️ Data sources & freshness

Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk
1 NDC mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Not available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2025
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.

⚠️ Practical billing caveats

  • A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
  • Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
  • Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
  • Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
  • The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
  • Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.

❓ J7402 billing FAQ

What is HCPCS code J7402?
J7402 is a HCPCS Level II J-code used to bill Mometasone furoate sinus implant, (sinuva), 10 micrograms under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J7402?
One unit of J7402 represents 10 MCG. Report the number of units equal to the dose administered divided by 10 MCG.
How many units of J7402 should I bill?
Divide the dose administered by the code's unit size (10 MCG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J7402?
The Medicare Part B payment limit is $11.345 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $11.118 per unit. Payment limits are revised quarterly.
Which NDCs bill under J7402?
1 NDC currently map to J7402 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J7402 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.