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See a sample rate comparisonHCPCS J7609 (Albuterol) 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.
Albuterol, inhalation solution, compounded product, administered through DME, unit dose, 1 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Inhalation Solutions |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility None |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J7609 |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 38779-0185-04 - ALBUTEROL SULFATE (U.S.P.) • 38779-0185-05 - ALBUTEROL SULFATE (U.S.P.) • 51927-1573-00 - ALBUTEROL SULFATE (U.S.P.) |
National average reimbursement for HCPCS J7609 by major payers:
$1.06
$0.76
$0.64
$0.49
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HCPCS J7609
5 of 25 sample ratesHigher to lower in this preview
Mississippi Baptist Medical Center, Inc
Mississippi Baptist Medical Center
$1.15Published rateTomah Memorial Hospital, Inc., Tomah Memorial Hospital
Tomah Memorial Hospital Inc
$0.75Published rateMajor Hospital, W.S. Major Hospital
Major Hospital
$0.75Published rateRedmond Park Hospital LLC, Redmond Hospital Based Services LLC
Redmond Park Hospital LLC
$0.75Published rateBridgeport Hospital
$0.55Published rate
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See a sample payer proposalHCPCS J7609 vs. Other Inhalation Solutions Codes
The HCPCS J7609 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 J7609 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 |
|---|---|---|
| 38779-0185-04-NDC | Moderate | ALBUTEROL SULFATE (U.S.P.) |
| 38779-0185-05-NDC | Moderate | ALBUTEROL SULFATE (U.S.P.) |
| 51927-1573-00-NDC | Moderate | ALBUTEROL SULFATE (U.S.P.) |
| J7609-HCPCS | Low | Albuterol, inhalation solution, compounded product, administered through DME, unit dose, 1 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7609. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7609 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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