HCPCS J7627 (Budesonide) 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 | • 20 - Urgent Care Facility • None • 11 - Office |
| Complexity Level | Low |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 38779-0198-00 - BUDESONIDE (MICRONIZED) • 38779-0198-03 - BUDESONIDE (MICRONIZED) • 38779-0198-05 - BUDESONIDE (MICRONIZED,MICRONIZED) • 38779-0198-06 - BUDESONIDE (MICRONIZED) • 51552-0668-01 - BUDESONIDE (MICRONIZED) |
National average reimbursement for HCPCS J7627 by major payers:
$1.32
$0.35
$0.61
$2.15
| 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 J7627 | ||||||
United | J7627 | $0.30 | 1295719789 - LOWER FLORENCE COUNTY HOSPITAL, LAKE CITY COMMUNITY HOSPITAL | 570427724 | SC | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.30 | 1760598700 - BETH ISRAEL DEACONESS HOSPITAL PLYMOUTH, INC. | 43009498 - (MA) JORDAN HOSPITAL ANESTHESIA ASSOCIATES, P.C. | MA | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.58 | 1891887071 - UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER, UCSF MEDICAL CENTER | 943281660 | CA | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.30 | 1679678486 - MEMORIAL HOSPITAL FLAGLER INC, ADVENTHEALTH PALM COAST | 592951990 - MEMORIAL HOSPITAL FLAGLER INC | FL | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.36 | 1366505463 - CLIFTON SPRINGS SANITARIUM CO, CLIFTON SPRINGS HOSPITAL AND CLINIC | 160743966 - (NY) CLIFTON SPRINGS SANITARIUM CO | NY | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.30 | 1164474755 - METHODIST MEDICAL CENTER OF ILLINOIS | 370661223 - METHODIST MEDICAL CENTER OF ILLINOIS | IL | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.36 | 1558743112 - JAMES LEE | 453023019 - (NY) NORTH SHORE-LIJ MEDICAL PC | NJ | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.66 | 1336244474 - UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, UCSF MEDICAL CENTER | 943281660 | CA | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.30 | 1588614325 - ST. CLOUD VAMC | 411768149 | MN | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.33 | 1831125087 - ASCENSION VIA CHRISTI HOSPITAL PITTSBURG, INC., MT. CARMEL REGIONAL MEDICAL CENTER, INC. | 480543778 - (KS) ASCENSION VIA CHRISTI HOSPITAL PITTSBURG INC | KS | General Acute Care Hospital (282N00000X) |
United | J7627 | $8.93 | 1528027240 - FAYETTE COMMUNITY HOSPITAL, INC., PIEDMONT FAYETTE HOSPITAL | 582322328 - (GA) FAYETTE COMMUNITY HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | J7627 | $6.53 | 1942208616 - ST. LUKE'S COMMUNITY HEALTH SERVICES, ST. LUKE'S THE WOODLANDS HOSPITAL | 760536234 - (TX) ST LUKES COMMUNITY HEALTH SERVICES | TX | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.30 | 1043394745 - MOUNT ST. MARY'S HOSPITAL OF NIAGARA FALLS, MOUNT ST. MARY'S HOSPITAL AND HEALTH CENTER | 161523353 - (NY) MOUNT ST MARYS HOSPITAL OF NIAGARA FALLS | NY | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.20 | 1457458150 - PRAKASH SHETTY | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
United | J7627 | $0.47 | 1851511489 - CHARLESTON AREA MEDICAL CENTER, INC., RIGHT FROM THE START | 550526150 - CHARLESTON AREA MEDICAL CENTER INC | WV | 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 |
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HCPCS J7627 vs. Other Inhalation Solutions Codes
The HCPCS J7627 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 J7627 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 |
|---|---|---|
| 38779-0198-00-NDC | Moderate | BUDESONIDE (MICRONIZED) |
| J7626-HCPCS | Low | Budesonide, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, up to 0.5 mg |
| J7627-HCPCS | Low | Budesonide, inhalation solution, compounded product, administered through DME, unit dose form, up to 0.5 mg |
| J7628-HCPCS | Low | Bitolterol mesylate, inhalation solution, compounded product, administered through DME, concentrated form, per milligram |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7627. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7627 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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