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See a sample rate comparisonHCPCS J7606 (Perforomist) 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.
Formoterol fumarate, inhalation solution, FDA approved final product, non-compounded, administered through DME, unit dose form, 20 micrograms
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Inhalation Solutions |
| Common Place of Service | None 99 - Other POS |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J7606 |
| Medicare Payment Limit | $2.728  |
| 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
Compare published rates across providers.
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HCPCS J7606
5 of 25 sample ratesHigher to lower in this preview
Auburn Community Hospital
$20.02Published rateDiana Sabirova
$2.51Published rateTruman Medical Center, Incorporated, University Health Lakewood Medical Center
Truman Medical Center Incorporated
$2.38Published rateLittle Rock Vamc, North Little Rock Vamc
Little Rock Vamc
$1.88Published rateDunstan Abraham
New York City Health And Hospitals Corporation
$1.87Published rate
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See a sample payer proposalHCPCS 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.
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