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HCPCS J7518 (Mycophenolic Acid) Fee Schedule

Last Verified: October 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Mycophenolic acid, oral, 180 mg
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Immunosuppressive Drugs

Common Place of Service

99 - Other POS

None

Complexity LevelLow
Medicaid Fee ScheduleView Medicaid rates for J7518
Medicare Payment Limit
$0.337BuyandBill.com
WAC Price
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Related NDC Codes

• 00078-0385-66 - MYFORTIC (K-30,FILM-COATED) 180 MG

• 00078-0386-66 - MYFORTIC (K-30,FILM-COATED) 360 MG

• 00904-6785-04 - MYCOPHENOLIC ACID (3X10) 180 MG

• 00904-6785-61 - MYCOPHENOLIC ACID (10X10) 180 MG

• 00904-6786-04 - MYCOPHENOLIC ACID (ENTERIC COATED) 360 MG


National average reimbursement for HCPCS J7518 by major payers:

bcbs

$0.45

uhc

$0.68

aetna

$0.75

cigna

$0.53

Compare published rates across providers.

Choose a payer to see a sample of rates for HCPCS J7518.

HCPCS J7518
5 of 25 sample ratesHigher to lower in this preview
  1. Cabell Huntington Hospital Inc

    WVGeneral Acute Care HospitalNPI 1679781264Tax ID 55-0675666

    $4.84Published rate
  2. Mgh

    Mass General Brigham Incorporated

    MAGeneral Acute Care HospitalNPI 1801015045Tax ID 42-807148

    $0.73Published rate
  3. Halifax Hospital Medical Center, Halifax Medical Center

    FLGeneral Acute Care HospitalNPI 1811991227Tax ID 59-2898487

    $0.47Published rate
  4. Hamiltion Inpatient Physicians, LLC

    Riverview Hospital

    INGeneral Acute Care HospitalNPI 1891821591Tax ID 35-1128943

    $0.43Published rate
  5. Gonzales Healthcare Systems, Memorial Hospital

    TXGeneral Acute Care HospitalNPI 1508859612Tax ID 74-1625013

    $0.18Published rate

National sample. Rates vary by location, specialty, and contract.

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HCPCS J7518 vs. Other Immunosuppressive Drugs Codes

The HCPCS J7518 code is part of the Drugs Administered Other than Oral Method services used for Immunosuppressive Drugs. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS J7518 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
00078-0385-66-NDCModerateMYFORTIC (K-30,FILM-COATED) 180 MG
00078-0386-66-NDCModerateMYFORTIC (K-30,FILM-COATED) 360 MG
00904-6785-04-NDCModerateMYCOPHENOLIC ACID (3X10) 180 MG
J7518-HCPCSLowMycophenolic acid, oral, 180 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7518. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J7518 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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