HCPCS J7606 (Perforomist) Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Drugs Administered Other than Oral Method • Inhalation Solutions |
| Common Place of Service | • None • 99 - Other POS |
| Complexity Level | Low |
| Medicare Payment Limit | |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00093-4061-06 - FORMOTEROL FUMARATE (60X2ML;SD) 20 MCG/2 ML • 00093-4061-30 - FORMOTEROL FUMARATE (30X2ML;SD) 20 MCG/2 ML • 00378-1631-91 - FORMOTEROL FUMARATE (60X2ML;SD) 20 MCG/2 ML • 00378-1631-93 - FORMOTEROL FUMARATE (30X2ML;SD) 20 MCG/2 ML • 00904-7454-11 - FORMOTEROL FUMARATE 20 MCG/2 ML |
National average reimbursement for HCPCS J7606 by major payers:

$3.79

$3.35

$4.13

$3.11
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS J7606 | ||||||
United | J7606 | $1.88 | 1164471991 - CHEYENNE VAMC | 830168494 | WY | General Acute Care Hospital (282N00000X) |
United | J7606 | $2.38 | 1780690180 - HOSPITAL SERVICE DISTRICT NO. 1 OF IBERIA PARISH, IBERIA MEDICAL CENTER | 726014963 | LA | General Acute Care Hospital (282N00000X) |
United | J7606 | $2.00 | 1194741181 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF PEDIATRICS, FPP | 113465690 | NY | General Acute Care Hospital (282N00000X) |
United | J7606 | $1.88 | 1194983510 - LYNN COUNTY HOSPITAL DISTRICT | 751328354 - (TX) LYNN COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | J7606 | $3.15 | 1972500452 - COMMUNITY HOSPITAL OF ANDERSON & MADISON COUNTY, INC | 351069822 - (IN) COMMUNITY HOSPITAL OF ANDERSON- MADISON COUNTY INC | IN | General Acute Care Hospital (282N00000X) |
United | J7606 | $2.40 | 1619916806 - ST JOSEPH MEDICAL CENTER, OSF SAINT JOSEPH MEDICAL CENTER | 383852646 - OSF MULTI-SPECIALTY GROUP | IL | General Acute Care Hospital (282N00000X) |
United | J7606 | $7.59 | 1396746228 - HIGH POINT REGIONAL HEALTH, HIGH POINT REGIONAL | 560532309 - (NC) HIGH POINT REGIONAL HEALTH | NC | General Acute Care Hospital (282N00000X) |
United | J7606 | $2.38 | 1598251498 - DAVID POLSTRA | 912146629 - SOUND INPATIENT PHYSICIANS, PLLC | CA | General Acute Care Hospital (282N00000X) |
United | J7606 | $2.38 | 1659320620 - CHARLESTON VAMC | 570720016 | SC | General Acute Care Hospital (282N00000X) |
United | J7606 | $2.00 | 1912245366 - EVELYN ERICKSON | 900603487 - (NY) PHYSICIAN AFFILIATE GROUP OF NEW YORK PC | NY | General Acute Care Hospital (282N00000X) |
United | J7606 | $3.15 | 1639264575 - CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY, ERLANGER MEDICAL CENTER | 626000101 - ERLANGER MEDICAL CENTER | TN | General Acute Care Hospital (282N00000X) |
United | J7606 | $2.38 | 1700821808 - PHC-LAS CRUCES INC, MEMORIAL MEDICAL CENTER OF LAS CRUCES | 270085482 | NM | General Acute Care Hospital (282N00000X) |
United | J7606 | $6.96 | 1720219231 - MONTEFIORE MEDICAL CENTER NORTH DIVISION | 131740114 - MONTEFIORE MEDICAL CENTER | NY | General Acute Care Hospital (282N00000X) |
United | J7606 | $1.88 | 1629015573 - LSUMC UNIVERSITY MEDICAL CENTER | 462605366 - (LA) UNIVERSITY HOSPITAL & CLINICS INC | LA | General Acute Care Hospital (282N00000X) |
United | J7606 | $2.38 | 1770536740 - BATES COUNTY MEMORIAL HOSPITAL | 436052772 - (MO) BATES COUNTY MEMORIAL HOSPITAL | MO | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
HCPCS J7606 vs. Other Inhalation Solutions Codes
The HCPCS J7606 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 J7606 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 |
|---|---|---|
| 00093-4061-06-NDC | Moderate | FORMOTEROL FUMARATE (60X2ML;SD) 20 MCG/2 ML |
| 00093-4061-30-NDC | Moderate | FORMOTEROL FUMARATE (30X2ML;SD) 20 MCG/2 ML |
| 00378-1631-91-NDC | Moderate | FORMOTEROL FUMARATE (60X2ML;SD) 20 MCG/2 ML |
| J7606-HCPCS | Low | Formoterol fumarate, inhalation solution, FDA approved final product, non-compounded, administered through DME, unit dose form, 20 micrograms |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7606. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7606 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS J7606) and we'll show you how you compare in 15 minutes or less.
