J7516
J7516 – Cyclosporin, parenteral, 250 mg · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 13 NDCs crosswalked per 250 MG $75.649/unit ASP+6%
📋 J7516 summary
J7516 is a HCPCS Level II J-code used to bill Cyclosporin, parenteral, 250 mg, billed per 250 MG. 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 J7516: Sandimmune
Code J7516
Billing unit 250 MG Payment limit $75.649/unit NDC-Crosswalk 13
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 codeJ7516
DescriptorCyclosporin, parenteral, 250 mg
Billing unit250 MG
Payment limit / unit$75.649
Est. ASP / unit$71.367 est.
Mapped NDCs13
Data periodQ3 2026
Last updated2026-09-20
💊 About Cyclosporine Injection DRUG GUIDE
Sandimmune injection, given with adrenal corticosteroids (steroid medicines), is used to help prevent the body from rejecting a transplanted kidney, liver, or heart.
It is also used to treat chronic rejection in patients who have already been treated with other immunosuppressive medicines.Sandimmune injection is reserved for patients who are unable to take Sandimmune capsules by mouth.
Because of the risk of a serious allergic reaction (anaphylaxis), the injection form is only used when the oral form is not an option.
Clinical overview from our editorial drug guide for Cyclosporine Injection. For billing reference, see the sections above.
🧾 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
$75.649
Est. ASP / unit
$71.367 est.
Est. after 2% sequester
$74.136
HCPCS dosage
250 MG
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 descriptionCyclosporin, parenteral, 250 mg
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment group—
Action codeN — No maintenance this year
Effective date2000-01-01
Date added2000-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J7516 = 250 mg. 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 J7516 WITH EST. MEDICARE PAY
13 NDCs map to J7516. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($75.649/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00078-0109-01 | Sandimmune cyclosporine 50 mg/mL INJECTION | Novartis | 10 AMPULE in 1 BOX (0078-0109-01) / 5 mL... | 50 mg/mL | 10 | $756.49 | — | ● Active | CMS + PDAC |
| 00574-0866-10 | Cyclosporine Injection | Padagis | — | — | 10 | $756.49 | — | — | CMS + PDAC |
| 62991-1533-05 | Cyclosporine A 1 g/g POWDER | LETCO | 25 g in 1 JAR (62991-1533-5) | 1 g/g | 4 | $302.60 | — | ● Active | PDAC |
| 62991-1533-01 | Cyclosporine A 1 g/g POWDER | LETCO | 5 g in 1 JAR (62991-1533-1) | 1 g/g | 4 | $302.60 | — | ● Active | PDAC |
| 62991-1533-02 | Cyclosporine A 1 g/g POWDER | LETCO | 100 g in 1 JAR (62991-1533-2) | 1 g/g | 4 | $302.60 | — | ● Active | PDAC |
| 51927-3196-00 | CYCLOSPORIN A (USP) | Unknown | — | — | 4 | $302.60 | — | — | PDAC |
| 51552-0663-02 | CYCLOSPORINE (1X5GM,USP) | Unknown | — | — | 4 | $302.60 | — | — | PDAC |
| 51552-0663-04 | CYCLOSPORINE (1X25GM,USP) | Unknown | — | — | 4 | $302.60 | — | — | PDAC |
| 38779-0660-03 | CYCLOSPORINE A 1 g/g POWDER | Medisca | 5 g in 1 BOTTLE, GLASS (38779-0660-3) | 1 g/g | 4 | $302.60 | — | ● Active | PDAC |
| 38779-0660-04 | CYCLOSPORINE A 1 g/g POWDER | Medisca | 25 g in 1 JAR (38779-0660-4) | 1 g/g | 4 | $302.60 | — | ● Active | PDAC |
| 38779-0660-05 | CYCLOSPORINE A 1 g/g POWDER | Medisca | 100 g in 1 JAR (38779-0660-5) | 1 g/g | 4 | $302.60 | — | ● Active | PDAC |
| 38779-0660-06 | CYCLOSPORINE A 1 g/g POWDER | Medisca | 1 g in 1 BOTTLE, GLASS (38779-0660-6) | 1 g/g | 4 | $302.60 | — | ● Active | PDAC |
| 51552-0663-01 | CYCLOSPORIN A | Unknown | — | — | 4 | $302.60 | — | — | PDAC |
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.
🗺️ Where J7516 is utilized
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The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.
📊 What bills under J7516
J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.
NDC products by ingredient
NDC products by labeler
🗃️ 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 2026-09-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
13 NDCs 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
No reportable utilization
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.
❓ J7516 billing FAQ
What is HCPCS code J7516?
J7516 is a HCPCS Level II J-code used to bill Cyclosporin, parenteral, 250 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J7516?
One unit of J7516 represents 250 MG. Report the number of units equal to the dose administered divided by 250 MG.
How many units of J7516 should I bill?
Divide the dose administered by the code's unit size (250 MG) 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 J7516?
The Medicare Part B payment limit is $75.649 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $74.136 per unit. Payment limits are revised quarterly.
Which NDCs bill under J7516?
13 NDCs currently map to J7516 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 J7516 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.