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See a sample rate comparisonHCPCS J7626 (Budesonide) 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.
Budesonide, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, up to 0.5 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Inhalation Solutions |
| Common Place of Service | 99 - Other POS None |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J7626 |
| Medicare Payment Limit | $1.351  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00093-6815-55 - BUDESONIDE (30X2ML,MICRONIZED) 0.25 MG/2 ML • 00093-6815-73 - BUDESONIDE (30X2ML,MICRONIZED) 0.25 MG/2 ML • 00093-6816-55 - BUDESONIDE (30X2ML,MICRONIZED) 0.5 MG/2 ML • 00093-6816-73 - BUDESONIDE (30X2ML,MICRONIZED) 0.5 MG/2 ML • 00093-6817-73 - BUDESONIDE (MICRONIZED) 1 MG/2 ML |
National average reimbursement for HCPCS J7626 by major payers:
$1.51
$1.80
$1.77
$1.48
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HCPCS J7626
5 of 25 sample ratesHigher to lower in this preview
North Shore Medical Center, Inc., North Shore Medical Center
$60.00Published rateHmh Hospitals Corporation, Jersey Shore University Medical Center
Hackensack Meridian Health Inc
$2.03Published ratePublic Health Trust Of Miami Dade County Florida, Jackson Health Systems Jackson Memorial Hospita
$1.40Published rateGrays Harbor Er Physicians
Grays Harbor Community Hospital
$1.23Published rateNew York City Health And Hospitals Corporation, Metropolitan Hospital Center
New York City Health And Hospitals Corporation
$0.93Published rate
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See a sample payer proposalHCPCS J7626 vs. Other Inhalation Solutions Codes
The HCPCS J7626 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 J7626 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 |
|---|---|---|
| 00093-6815-55-NDC | Moderate | BUDESONIDE (30X2ML,MICRONIZED) 0.25 MG/2 ML |
| 00093-6815-73-NDC | Moderate | BUDESONIDE (30X2ML,MICRONIZED) 0.25 MG/2 ML |
| 00093-6816-55-NDC | Moderate | BUDESONIDE (30X2ML,MICRONIZED) 0.5 MG/2 ML |
| J7626-HCPCS | Low | Budesonide, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, up to 0.5 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7626. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7626 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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