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HCPCS J7606 (Perforomist) Fee Schedule

Last Verified: November 2025

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 FactDetail
Service Type

Drugs Administered Other than Oral Method

Inhalation Solutions

Common Place of Service

None

99 - Other POS

Complexity LevelLow
Medicare Payment Limit
$2.728BuyandBill.com
WAC Price
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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:

bcbs

$3.79

uhc

$3.35

aetna

$4.13

cigna

$3.11

Preview provider-level rates for...
For billing codeHCPCS J7606
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J7606

United
J7606$1.881164471991 - CHEYENNE VAMC830168494WYGeneral Acute Care Hospital (282N00000X)
United
J7606$2.381780690180 - HOSPITAL SERVICE DISTRICT NO. 1 OF IBERIA PARISH, IBERIA MEDICAL CENTER726014963LAGeneral Acute Care Hospital (282N00000X)
United
J7606$2.001194741181 - NASSAU HEALTH CARE CORPORATION, NUMC DEPARTMENT OF PEDIATRICS, FPP113465690NYGeneral Acute Care Hospital (282N00000X)
United
J7606$1.881194983510 - LYNN COUNTY HOSPITAL DISTRICT751328354 - (TX) LYNN COUNTY HOSPITAL DISTRICTTXGeneral Acute Care Hospital (282N00000X)
United
J7606$3.151972500452 - COMMUNITY HOSPITAL OF ANDERSON & MADISON COUNTY, INC351069822 - (IN) COMMUNITY HOSPITAL OF ANDERSON- MADISON COUNTY INCINGeneral Acute Care Hospital (282N00000X)
United
J7606$2.401619916806 - ST JOSEPH MEDICAL CENTER, OSF SAINT JOSEPH MEDICAL CENTER383852646 - OSF MULTI-SPECIALTY GROUPILGeneral Acute Care Hospital (282N00000X)
United
J7606$7.591396746228 - HIGH POINT REGIONAL HEALTH, HIGH POINT REGIONAL560532309 - (NC) HIGH POINT REGIONAL HEALTHNCGeneral Acute Care Hospital (282N00000X)
United
J7606$2.381598251498 - DAVID POLSTRA912146629 - SOUND INPATIENT PHYSICIANS, PLLCCAGeneral Acute Care Hospital (282N00000X)
United
J7606$2.381659320620 - CHARLESTON VAMC570720016SCGeneral Acute Care Hospital (282N00000X)
United
J7606$2.001912245366 - EVELYN ERICKSON900603487 - (NY) PHYSICIAN AFFILIATE GROUP OF NEW YORK PCNYGeneral Acute Care Hospital (282N00000X)
United
J7606$3.151639264575 - CHATTANOOGA HAMILTON COUNTY HOSPITAL AUTHORITY, ERLANGER MEDICAL CENTER626000101 - ERLANGER MEDICAL CENTERTNGeneral Acute Care Hospital (282N00000X)
United
J7606$2.381700821808 - PHC-LAS CRUCES INC, MEMORIAL MEDICAL CENTER OF LAS CRUCES270085482NMGeneral Acute Care Hospital (282N00000X)
United
J7606$6.961720219231 - MONTEFIORE MEDICAL CENTER NORTH DIVISION131740114 - MONTEFIORE MEDICAL CENTERNYGeneral Acute Care Hospital (282N00000X)
United
J7606$1.881629015573 - LSUMC UNIVERSITY MEDICAL CENTER462605366 - (LA) UNIVERSITY HOSPITAL & CLINICS INCLAGeneral Acute Care Hospital (282N00000X)
United
J7606$2.381770536740 - BATES COUNTY MEMORIAL HOSPITAL436052772 - (MO) BATES COUNTY MEMORIAL HOSPITALMOGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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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.

CodeComplexityDescription
00093-4061-06-NDCModerateFORMOTEROL FUMARATE (60X2ML;SD) 20 MCG/2 ML
00093-4061-30-NDCModerateFORMOTEROL FUMARATE (30X2ML;SD) 20 MCG/2 ML
00378-1631-91-NDCModerateFORMOTEROL FUMARATE (60X2ML;SD) 20 MCG/2 ML
J7606-HCPCSLowFormoterol 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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