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See a sample rate comparisonHCPCS J7639 (Pulmozyme) 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.
Dornase alfa, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose form, per milligram
| 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 J7639 |
| Medicare Payment Limit | $55.162  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 50242-0100-39 - PULMOZYME (AMP,INNER NDC) 2.5 MG/2.5 ML • 50242-0100-40 - PULMOZYME (AMP) 2.5 MG/2.5 ML |
National average reimbursement for HCPCS J7639 by major payers:
$55.87
$54.49
$57.39
$56.78
Compare published rates across providers.
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HCPCS J7639
5 of 25 sample ratesHigher to lower in this preview
Jessica Hayward
$102.12Published rateNew York City Health And Hospitals Corporation, Harlem Hospital Center
New York City Health And Hospitals Corporation
$56.81Published rateOklahoma City Vamc
$53.59Published rateHospital Service District No. 1 Of Iberia Parish, Iberia Medical Center
$53.47Published rateMathew Negari
New York City Health And Hospitals Corporation
$41.93Published rate
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See a sample payer proposalHCPCS J7639 vs. Other Inhalation Solutions Codes
The HCPCS J7639 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 J7639 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 |
|---|---|---|
| 50242-0100-39-NDC | Moderate | PULMOZYME (AMP,INNER NDC) 2.5 MG/2.5 ML |
| 50242-0100-40-NDC | Moderate | PULMOZYME (AMP) 2.5 MG/2.5 ML |
| J7638-HCPCS | Low | Dexamethasone, inhalation solution, compounded product, administered through DME, unit dose form, per milligram |
| J7639-HCPCS | Low | Dornase alfa, inhalation solution, FDA-approved final product, non-compounded, administered through DME, unit dose 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 J7639. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7639 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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