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J7631

J7631 – Cromolyn sodium, inhalation solution, fda-approved final product, non-co · NDC Crosswalk & Billing Units

HCPCS Level II J-code · Medicare Part B drug billing
J-code ● 6 NDCs crosswalked per 10 MG $0.691/unit ASP+6%

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

📋 J7631 summary

J7631 is a HCPCS Level II J-code used to bill Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administ..., billed per 10 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 J7631: Cromolyn Sodium Inhalation Solution

Code J7631 Billing unit 10 MG Payment limit $0.691/unit NDC-Crosswalk 6 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 codeJ7631
DescriptorCromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams
Billing unit10 MG
Payment limit / unit$0.691
Est. ASP / unit$0.652 est.
Mapped NDCs6
Data periodQ3 2026
Last updated2026-08-20

💊 About Cromolyn Oral Inhalation DRUG GUIDE

Cromolyn sodium inhalation solution is used on a regular, daily basis to help manage bronchial asthma in adults and children two years of age and older.

It works best as a preventive medicine — it will not stop an asthma attack that has already started.It can also be used as a single dose taken shortly before exposure to known triggers — such as exercise, cold dry air, animal dander, or environmental pollutants — to help prevent the sudden airway tightening those triggers can cause.

Read the full Cromolyn Oral Inhalation drug guide →
Clinical overview from our editorial drug guide for Cromolyn Oral Inhalation. 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
$0.691
Est. ASP / unit
$0.652 est.
Est. after 2% sequester
$0.677
HCPCS dosage
10 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 descriptionCromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2D1G
ASC payment group—
Action codeN — No maintenance this year
Effective date2008-01-01
Date added2000-01-01
Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J7631 = 10 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 J7631 LEAST EXPENSIVE FIRST

6 NDCs map to J7631. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($0.691/unit) × that package's bill units.
NDC (11-digit)DrugLabelerPackageStrength Bill units Est. pay / pkg NADAC / unit StatusSource
00172-6406-49 Cromolyn Sodium 20 mg/2mL SOLUTION Teva 12 POUCH in 1 CARTON (0172-6406-49) / 5 V... 20 mg/2mL 120 $82.92 $0.981 ● Active CMS + PDAC
76204-0028-60 Cromolyn Sodium Inhalation Solution 20 mg/2mL SOLUTION Ritedose 2 POUCH in 1 CARTON (76204-028-60) / 30 A... 20 mg/2mL 120 $82.92 $0.981 Obsolete CMS + PDAC
42571-0350-09 Cromolyn Sodium 20 mg/2mL INHALANT Micro 5 CARTON in 1 CARTON (42571-350-09) / 12... 20 mg/2mL 1 $0.69 $0.981 Obsolete PDAC
69543-0456-60 CROMOLYN SODIUM (5X12,PF) 10 MG/1 ML Unknown — — 1 $0.69 — — PDAC
48102-0033-60 CROMOLYN SODIUM (5X12,PF) 10 MG/1 ML Unknown — — 1 $0.69 — — PDAC
69784-0205-60 CROMOLYN SODIUM 10 MG/1 ML Unknown — — 1 $0.69 — — 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.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period
Total Part B spend
$27.6K
Claims
175
Beneficiaries
125
Spend / beneficiary
$220.62
Spend / claim
$157.59
Trend by period
Where J7631 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #636 of 824
#631 DUAL LAYER IMPAX, PE... Q4262 $31K #632 CEFEPIME HCL J0692 $30.3K #633 MODERNA COVID (6M-1... 91321 $30.1K #634 MEROPENEM(J2185) J2185 $28.1K #635 CYGNUS, PER SQ CM** Q4170 $28K #636 CROMOLYN SODIUM J7631 $27.6K #637 LINCOCIN* J2010 $27.1K #638 ARANESP(J0882) J0882 $25.4K #639 VINCASAR PFS* J9370 $24.6K #640 HYPERHEP B* 90371 $24.3K #641 ENOXAPARIN SODIUM* J1650 $24.3K
Total claims — #564 of 824
#559 SUBLOCADE(Q9991) Q9991 183 #560 PROGRAF(J7521) J7521 182 #561 HYDRALAZINE HCL J0360 180 #562 AMNICORE PRO+, PER S... Q4299 176 #563 PHENTOLAMINE MESYLAT... J2760 175 #564 CROMOLYN SODIUM J7631 175 #565 BESPONSA J9229 175 #566 PANHEMATIN J1640 174 #567 STELARA(J3358)* J3358 173 #568 IMIPENEM-CILASTATIN... J0743 172 #569 QALSODY J1304 172

Full breakdown by period (2)
PeriodTotal spendBeneficiariesClaims$/beneficiary$/claim
2026 (Q1) $27.6K 125 175 $220.62 $157.59
2025 (Q1-Q4) $57.3K 286 922 $200.43 $62.17
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
$58.6K
Medicare paid
$44K
Submitted services
186,446
Denial rate
3.7%
Allowed / service
$0.33
Submitted charges
$900.3K
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.

🗺️ Where J7631 is utilized CMS · BY PROVIDER · 2024

Medicare Part B services for this code by the rendering provider's state — 112 services across 1 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.

📊 What bills under J7631

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
Cromolyn Sodium 2
Cromolyn Sodium Inhalation Solutio... 1
NDC products by labeler
Teva Pharmaceuticals USA, Inc. 1
Micro Labs Limited 1
Ritedose Pharmaceuticals, LLC 1

🗃️ 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 + DMEPDAC (PDAC)
6 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
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.

❓ J7631 billing FAQ

What is HCPCS code J7631?
J7631 is a HCPCS Level II J-code used to bill Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J7631?
One unit of J7631 represents 10 MG. Report the number of units equal to the dose administered divided by 10 MG.
How many units of J7631 should I bill?
Divide the dose administered by the code's unit size (10 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 J7631?
The Medicare Part B payment limit is $0.691 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $0.677 per unit. Payment limits are revised quarterly.
Which NDCs bill under J7631?
6 NDCs currently map to J7631 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 J7631 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.