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See a sample rate comparisonHCPCS J7601 (Ohtuvayre) 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.
Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Inhalation Solutions |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J7601 |
| Medicare Payment Limit | $52.117  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J7601 by major payers:
$54.01
$53.89
$108.14
$221.27
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HCPCS J7601
5 of 25 sample ratesHigher to lower in this preview
University Of California Irvine, Uci Medical Center
Regents Of The University Of California At Irvine
$205.49Published rateTulane University Medical Group
The Administrators Of The Tulane Educational Fund
$66.83Published rateMercy Health, Harness Health Pharmacy
Mercy Health - Tiffin Hospital LLC
$50.65Published rateCincinnati Vamc, Fort Thomas Vamc
Cincinnati Vamc
$50.65Published rateAdrielle El-Dyson Otoo
New York City Health And Hospitals Corporation
$33.47Published rate
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See a sample payer proposalHCPCS J7601 vs. Other Inhalation Solutions Codes
The HCPCS J7601 code is part of the Drugs Administered Other than Oral Method services used for Inhalation Solutions. 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 J7601 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.
| Code | Complexity | Description |
|---|---|---|
| J7601-HCPCS | Low | Ensifentrine, inhalation suspension, fda approved final product, non-compounded, administered through dme, unit dose form, 3 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7601. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7601 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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