J7606
J7606 – Formoterol fumarate, inhalation solution, fda approved final product, no · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 32 NDCs crosswalked per 20 MCG $1.547/unit ASP+6%
📋 J7606 summary
J7606 is a HCPCS Level II J-code used to bill Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, admi..., billed per 20 MCG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.
Brand names associated with J7606: Formoterol Fumarate, Perforomist, Formoterol Fumarate Inhalation Solution
Code J7606
Billing unit 20 MCG Payment limit $1.547/unit NDC-Crosswalk 32
Quarter Q3 2026
RxCUI Atlas Trace the drug concept →
⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.
🗂️ Key billing facts
HCPCS codeJ7606
DescriptorFormoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms
Billing unit20 MCG
Payment limit / unit$1.547
Est. ASP / unit$1.459 est.
Mapped NDCs32
Data periodQ3 2026
Last updated2026-08-20
💊 About Formoterol Oral Inhalation DRUG GUIDE
Formoterol fumarate inhalation solution is used for the long-term maintenance treatment of airway narrowing (bronchoconstriction) in adults with COPD, including chronic bronchitis and emphysema.
It is taken twice daily — morning and evening — as a regular, ongoing treatment.Important limits: This medication is not for relieving sudden COPD flare-ups or breathlessness in the moment, and it is not approved to treat asthma.
A separate short-acting inhaler should always be on hand for sudden symptoms.
Clinical overview from our editorial drug guide for Formoterol Oral Inhalation. For billing reference, see the sections above.
🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026
📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).
Medicare payment limit / unit
$1.547
Est. ASP / unit
$1.459 est.
Est. after 2% sequester
$1.516
HCPCS dosage
20 MCG
The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.
Full HCPCS code details (official CMS record)
Long descriptionFormoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms
CoverageC — Carrier/MAC judgment
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2D1G
ASC payment group—
Action codeN — No maintenance this year
Effective date2009-01-01
Date added2009-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J7606 = 20 mcg. Enter a regimen to convert dose → billing units and project a full course.
Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.
🔁 NDCs that bill under J7606 LEAST EXPENSIVE FIRST
32 NDCs map to J7606. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($1.547/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00378-1631-93 | FORMOTEROL FUMARATE 20 ug/2mL SOLUTION | Mylan | 30 POUCH in 1 CARTON (0378-1631-93) / 1 V... | 20 ug/2mL | 30 | $46.41 | $1.284 | ● Active | CMS + PDAC |
| 42571-0463-73 | Formoterol fumarate 20 ug/2mL SOLUTION | Micro | 30 POUCH in 1 CARTON (42571-463-73) / 1 V... | 20 ug/2mL | 30 | $46.41 | $1.284 | ● Active | CMS ASP |
| 43598-0778-30 | Formoterol Fumarate 20 ug/2mL SOLUTION | Dr. | 30 POUCH in 1 CARTON (43598-778-30) / 1 V... | 20 ug/2mL | 30 | $46.41 | $1.284 | ● Active | CMS + PDAC |
| 50742-0394-30 | Formoterol Fumarate .02 mg/2mL SOLUTION | Ingenus | 30 POUCH in 1 CARTON (50742-394-30) / 1 V... | .02 mg/2mL | 30 | $46.41 | $1.284 | ● Active | CMS + PDAC |
| 62332-0655-30 | Formoterol Fumarate 20 ug/2mL SOLUTION | Alembic | 30 POUCH in 1 CARTON (62332-655-30) / 1 V... | 20 ug/2mL | 30 | $46.41 | $1.284 | ● Active | CMS + PDAC |
| 70748-0261-30 | formoterol fumarate 20 ug/2mL SOLUTION | Lupin | 30 POUCH in 1 CARTON (70748-261-30) / 1 V... | 20 ug/2mL | 30 | $46.41 | $1.284 | ● Active | CMS + PDAC |
| 70756-0608-70 | Formoterol fumarate 20 ug/2mL SOLUTION | Lifestar | 30 POUCH in 1 CARTON (70756-608-70) / 1 V... | 20 ug/2mL | 30 | $46.41 | $1.284 | ● Active | CMS + PDAC |
| 72603-0620-30 | Formoterol fumarate 20 ug/2mL SOLUTION | NorthStar | 30 POUCH in 1 CARTON (72603-620-30) / 1 V... | 20 ug/2mL | 30 | $46.41 | $1.284 | ● Active | CMS + PDAC |
| 76204-0030-01 | Formoterol Fumarate Inhalation Solution formoterol fumarate dihydrate 20 ug/2mL SOLUTION | Ritedose | 30 POUCH in 1 CARTON (76204-030-01) / 1 V... | 20 ug/2mL | 30 | $46.41 | $1.284 | ● Active | CMS + PDAC |
| 73043-0051-93 | Formoterol fumarate 20 ug/2mL SOLUTION | Devatis, | 30 POUCH in 1 CARTON (73043-051-93) / 1 V... | 20 ug/2mL | 0.5 | $0.77 | $1.284 | ● Active | PDAC |
| 00093-4061-30 | Formoterol fumarate 20 ug/2mL SOLUTION | Teva | 30 POUCH in 1 CARTON (0093-4061-30) / 1 V... | 20 ug/2mL | 0.5 | $0.77 | $1.284 | ● Active | PDAC |
| 00093-4061-06 | Formoterol fumarate 20 ug/2mL SOLUTION | Teva | 60 POUCH in 1 CARTON (0093-4061-06) / 1 V... | 20 ug/2mL | 60 | $92.82 | $1.337 | ● Active | CMS + PDAC |
| 00378-1631-91 | FORMOTEROL FUMARATE 20 ug/2mL SOLUTION | Mylan | 60 POUCH in 1 CARTON (0378-1631-91) / 1 V... | 20 ug/2mL | 60 | $92.82 | $1.337 | ● Active | CMS + PDAC |
| 42571-0463-62 | Formoterol fumarate 20 ug/2mL SOLUTION | Micro | 60 POUCH in 1 CARTON (42571-463-62) / 1 V... | 20 ug/2mL | 60 | $92.82 | $1.337 | ● Active | CMS + PDAC |
| 43598-0778-60 | Formoterol Fumarate 20 ug/2mL SOLUTION | Dr. | 60 POUCH in 1 CARTON (43598-778-60) / 1 V... | 20 ug/2mL | 60 | $92.82 | $1.337 | ● Active | CMS + PDAC |
| 50742-0394-60 | Formoterol Fumarate .02 mg/2mL SOLUTION | Ingenus | 60 POUCH in 1 CARTON (50742-394-60) / 1 V... | .02 mg/2mL | 60 | $92.82 | $1.337 | ● Active | CMS + PDAC |
| 62332-0655-60 | Formoterol Fumarate 20 ug/2mL SOLUTION | Alembic | 60 POUCH in 1 CARTON (62332-655-60) / 1 V... | 20 ug/2mL | 60 | $92.82 | $1.337 | ● Active | CMS + PDAC |
| 70748-0261-60 | formoterol fumarate 20 ug/2mL SOLUTION | Lupin | 60 POUCH in 1 CARTON (70748-261-60) / 1 V... | 20 ug/2mL | 60 | $92.82 | $1.337 | ● Active | CMS + PDAC |
| 70756-0608-60 | Formoterol fumarate 20 ug/2mL SOLUTION | Lifestar | 60 POUCH in 1 CARTON (70756-608-60) / 4 V... | 20 ug/2mL | 60 | $92.82 | $1.337 | ● Active | CMS + PDAC |
| 72603-0620-60 | Formoterol fumarate 20 ug/2mL SOLUTION | NorthStar | 60 POUCH in 1 CARTON (72603-620-60) / 4 V... | 20 ug/2mL | 60 | $92.82 | $1.337 | ● Active | CMS + PDAC |
| 76204-0030-02 | Formoterol Fumarate Inhalation Solution formoterol fumarate dihydrate 20 ug/2mL SOLUTION | Ritedose | 60 POUCH in 1 CARTON (76204-030-02) / 1 V... | 20 ug/2mL | 60 | $92.82 | $1.337 | ● Active | CMS + PDAC |
| 73043-0051-96 | Formoterol fumarate 20 ug/2mL SOLUTION | Devatis, | 60 POUCH in 1 CARTON (73043-051-96) / 1 V... | 20 ug/2mL | 0.5 | $0.77 | $1.337 | ● Active | PDAC |
| 00904-7454-14 | Formoterol fumarate 20 ug/2mL SOLUTION | Major | 60 POUCH in 1 CARTON (0904-7454-14) / 4 V... | 20 ug/2mL | 0.5 | $0.77 | $1.511 | Obsolete | PDAC |
| 00904-7454-11 | Formoterol fumarate 20 ug/2mL SOLUTION | Major | 30 POUCH in 1 CARTON (0904-7454-11) / 1 V... | 20 ug/2mL | 0.5 | $0.77 | $1.871 | Obsolete | PDAC |
| 49502-0605-30 | Perforomist formoterol fumarate dihydrate 20 ug/2mL SOLUTION | Viatris | 30 POUCH in 1 CARTON (49502-605-30) / 1 V... | 20 ug/2mL | 30 | $46.41 | $10.049 | ● Active | CMS + PDAC |
| 49502-0605-61 | Perforomist formoterol fumarate dihydrate 20 ug/2mL SOLUTION | Viatris | 60 POUCH in 1 CARTON (49502-605-61) / 1 V... | 20 ug/2mL | 60 | $92.82 | $10.116 | ● Active | CMS + PDAC |
| 42858-0094-35 | Formoterol Fumarate | Rhodes | — | — | 30 | $46.41 | — | — | CMS + PDAC |
| 42858-0094-62 | Formoterol Fumarate | Rhodes | — | — | 60 | $92.82 | — | — | CMS + PDAC |
| 73289-0060-01 | Formoterol Fumarate | Aucta | — | — | 30 | $46.41 | — | — | CMS + PDAC |
| 73289-0060-02 | Formoterol Fumarate | Aucta | — | — | 60 | $92.82 | — | — | CMS + PDAC |
| 70644-0215-60 | FORMOTEROL FUMARATE W/PARI LC PLUS NEBULIZER 20 MCG/2 ML | Unknown | — | — | 0.5 | $0.77 | — | — | PDAC |
| 70644-0215-30 | FORMOTEROL FUMARATE W/PARI LC PLUS NEBULIZER 20 MCG/2 ML | Unknown | — | — | 0.5 | $0.77 | — | — | PDAC |
NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$3.83M
Claims
29,560
Beneficiaries
14,908
Spend / beneficiary
$256.95
Spend / claim
$129.59
Trend by period
Where J7606 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #264 of 824
#259
ONPATTRO J0222
$4.09M
#260
ILUVIEN J7313
$4.02M
#261
AXTLE J9292
$4.01M
#262
TRELSTAR J3315
$3.85M
#263
RIABNI Q5123
$3.85M
#264
FORMOTEROL FUMARATE* J7606
$3.83M
#265
FOCINVEZ J1434
$3.77M
#266
APRETUDE J0739
$3.76M
#267
ELOCTATE J7205
$3.72M
#268
IODIXANOL(Q9967)* Q9967
$3.58M
#269
BACLOFEN(J0475)* J0475
$3.51M
Total claims — #80 of 824
#75
RETACRIT(Q5106) Q5106
33,752
#76
LEVULAN J7308
31,923
#77
FERAHEME(Q0138)* Q0138
31,621
#78
EPOGEN(J0885)* J0885
31,448
#79
PRIVIGEN J1459
30,530
#80
FORMOTEROL FUMARATE* J7606
29,560
#81
FLUCELVAX * 90661
29,549
#82
INJECTAFER J1439
29,106
#83
ENTYVIO J3380
28,749
#84
ADMELOG SOLOSTAR* J1817
28,262
#85
GENVISC 850 J7320
27,330
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $3.83M | 14,908 | 29,560 | $256.95 | $129.59 |
| 2025 (Q1-Q4) | $17.83M | 24,849 | 146,296 | $717.61 | $121.89 |
Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.
📈 Medicare Part B claims detail CMS PSPS · 2024
Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.
Allowed charges
$18.14M
Medicare paid
$13.65M
Submitted services
9,051,498
Denial rate
3.3%
Allowed / service
$2.07
Submitted charges
$172.17M
Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.
🗺️ Where J7606 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 107 services across 1 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.
Hover or tap a state to see its numbers + top ZIP codes.
Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.
📊 What bills under J7606
J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.
NDC products by ingredient
NDC products by labeler
🗃️ Data sources & freshness
Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.
HCPCS code & descriptor
CMS HCPCS Level II code file
Loaded
Payment limit & billing unit
CMS Medicare Part B ASP Pricing File (quarterly)
Q3 2026 · as of 2026-08-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
32 NDCs mapped
NADAC acquisition cost
CMS National Average Drug Acquisition Cost (weekly)
Available for mapped NDCs
Utilization & spend
CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners
Latest data year 2026
Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.
⚠️ Practical billing caveats
- A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
- Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
- Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
- Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
- The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
- Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.
❓ J7606 billing FAQ
What is HCPCS code J7606?
J7606 is a HCPCS Level II J-code used to bill Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J7606?
One unit of J7606 represents 20 MCG. Report the number of units equal to the dose administered divided by 20 MCG.
How many units of J7606 should I bill?
Divide the dose administered by the code's unit size (20 MCG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.
How much does Medicare pay for J7606?
The Medicare Part B payment limit is $1.547 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $1.516 per unit. Payment limits are revised quarterly.
Which NDCs bill under J7606?
32 NDCs currently map to J7606 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.
Does a crosswalk mean J7606 is covered?
No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.
For professional billing reference only — verify against the current CMS files before submitting claims.