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See a sample rate comparisonHCPCS J7604 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.
Acetylcysteine, inhalation solution, compounded product, administered through DME, unit dose form, per gram
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Inhalation Solutions |
| Common Place of Service | None 11 - Office 20 - Urgent Care Facility |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J7604 |
| Related NDC Codes | • 38779-0495-04 - ACETYLCYSTEINE (U.S.P.) • 38779-0495-05 - ACETYLCYSTEINE (U.S.P.) • 38779-0495-08 - ACETYLCYSTEINE (U.S.P.) • 38779-0495-09 - ACETYLCYSTEINE (U.S.P.) • 51552-0201-04 - ACETYLCYSTEINE (U.S.P.,N.F.) |
National average reimbursement for HCPCS J7604 by major payers:
$0.01
$1,000,000.00
$89.00
$8.34
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS J7604.
HCPCS J7604
5 of 6 sample ratesHigher to lower in this preview
South Nassau Communities Hospital
$64.00Published rateMontefiore Mount Vernon Hospital, Montefiore Mount Vernon Professional Billing
Montefiore Mount Vernon Hospital
$64.00Published rateMontefiore New Rochelle Hospital, Montefiore New Rochelle Professional Billing
Montefiore New Rochelle Hospital
$64.00Published rateSouth Nassau Communities Hospital
$64.00Published rateMontefiore Mount Vernon Hospital, Montefiore Mount Vernon Professional Billing
Montefiore Mount Vernon Hospital
$64.00Published rate
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See a sample payer proposalHCPCS J7604 vs. Other Inhalation Solutions Codes
The HCPCS J7604 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 J7604 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 |
|---|---|---|
| 38779-0495-04-NDC | Moderate | ACETYLCYSTEINE (U.S.P.) |
| 38779-0495-05-NDC | Moderate | ACETYLCYSTEINE (U.S.P.) |
| 38779-0495-08-NDC | Moderate | ACETYLCYSTEINE (U.S.P.) |
| J7604-HCPCS | Low | Acetylcysteine, inhalation solution, compounded product, administered through DME, unit dose form, per gram |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7604. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7604 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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