Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS J7631 (Cromolyn Sodium) 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.
Cromolyn sodium, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, per 10 milligrams
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Inhalation Solutions |
| Common Place of Service | 99 - Other POS None 20 - Urgent Care Facility |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J7631 |
| Medicare Payment Limit | $0.437  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00172-6406-49 - CROMOLYN SODIUM (VIAL) 10 MG/ML • 42571-0350-09 - CROMOLYN SODIUM (5X12,PF) 10 MG/1 ML • 48102-0033-60 - CROMOLYN SODIUM (5X12,PF) 10 MG/1 ML • 69784-0205-60 - CROMOLYN SODIUM 10 MG/1 ML • 76204-0028-60 - CROMOLYN SODIUM (2X30,PF) 10 MG/1 ML |
National average reimbursement for HCPCS J7631 by major payers:
$0.66
$0.64
$0.72
$0.59
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS J7631.
HCPCS J7631
5 of 25 sample ratesHigher to lower in this preview
Ucsf Medical Center
$7.30Published rateLior Shabtai
North Shore-Lij Medical PC
$0.57Published rateGrinnell Regional Medical Center, Unitypoint Health - Grinnell Regional Medical Center
Grinnell Regional Medical Center
$0.43Published rateDimitry Hikin
Chs Physician Partners PC
$0.21Published rateGonzales Healthcare Systems
$0.20Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS J7631 vs. Other Inhalation Solutions Codes
The HCPCS J7631 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 J7631 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 |
|---|---|---|
| 00172-6406-49-NDC | Moderate | CROMOLYN SODIUM (VIAL) 10 MG/ML |
| 42571-0350-09-NDC | Moderate | CROMOLYN SODIUM (5X12,PF) 10 MG/1 ML |
| 48102-0033-60-NDC | Moderate | CROMOLYN SODIUM (5X12,PF) 10 MG/1 ML |
| J7631-HCPCS | Low | Cromolyn sodium, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, per 10 milligrams |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7631. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7631 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS J7631) and we'll show you how you compare in 15 minutes or less.