J7626
J7626 – Budesonide, inhalation solution, fda-approved final product, non-compoun · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 46 NDCs crosswalked per 0.5 MG $1.092/unit ASP+6%
📋 J7626 summary
J7626 is a HCPCS Level II J-code used to bill Budesonide, inhalation solution, fda-approved final product, non-compounded, administered..., billed per 0.5 MG. 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 J7626: Budesonide, Budesonide Inhalation, Pulmicort Respules
Code J7626
Billing unit 0.5 MG Payment limit $1.092/unit NDC-Crosswalk 46
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 codeJ7626
DescriptorBudesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg
Billing unit0.5 MG
Payment limit / unit$1.092
Est. ASP / unit$1.030 est.
Mapped NDCs46
Data periodQ3 2026
Last updated2026-09-20
💊 About Budesonide Oral Inhalation DRUG GUIDE
The supported label is for budesonide inhalation suspension, the nebulizer form (Pulmicort Respules).
It is used for maintenance treatment of asthma and to help prevent asthma symptoms in children 12 months to 8 years of age.It is not a rescue medicine.
It does not relieve sudden asthma attacks or acute bronchospasm (sudden tightening of the airways).
Clinical overview from our editorial drug guide for Budesonide 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
$1.092
Est. ASP / unit
$1.030 est.
Est. after 2% sequester
$1.070
HCPCS dosage
0.5 MG
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 descriptionBudesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg
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 date2007-01-01
Date added2002-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J7626 = 0.5 mg. 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 J7626 LEAST EXPENSIVE FIRST
46 NDCs map to J7626. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($1.092/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00093-6816-55 | Budesonide .5 mg/2mL SUSPENSION | Teva | 30 POUCH in 1 CARTON (0093-6816-55) / 1 V... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 00093-6816-73 | Budesonide .5 mg/2mL SUSPENSION | Teva | 6 POUCH in 1 CARTON (0093-6816-73) / 5 VI... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 00115-1689-74 | Budesonide Inhalation .5 mg/2mL SUSPENSION | Amneal | 6 POUCH in 1 CARTON (0115-1689-74) / 5 VI... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 00487-9701-01 | Budesonide .5 mg/2mL INHALANT | Nephron | 6 POUCH in 1 CARTON (0487-9701-01) / 5 AM... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 00487-9701-30 | Budesonide .5 mg/2mL INHALANT | Nephron | 30 POUCH in 1 CARTON (0487-9701-30) / 1 A... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 47335-0632-49 | Budesonide .5 mg/2mL SUSPENSION | Sun | 6 POUCH in 1 CARTON (47335-632-49) / 5 AM... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 60687-0524-83 | Budesonide Inhalation .5 mg/2mL SUSPENSION | American | 30 POUCH in 1 CARTON (60687-524-83) / 1 A... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS ASP |
| 62135-0823-84 | Budesonide .5 mg/2mL SUSPENSION | Chartwell | 6 POUCH in 1 CARTON (62135-823-84) / 5 AM... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 64980-0639-03 | Budesonide .5 mg/2mL INHALANT | Rising | 30 POUCH in 1 CARTON (64980-639-03) / 5 A... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 68180-0984-30 | budesonide inhalation .5 mg/2mL SUSPENSION | Lupin | 6 POUCH in 1 CARTON (68180-984-30) / 5 AM... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 69097-0319-53 | Budesonide Inhalation Suspension .5 mg/2mL INHALANT | Cipla | 30 POUCH in 1 CARTON (69097-319-53) / 1 A... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 69097-0319-87 | Budesonide Inhalation Suspension .5 mg/2mL INHALANT | Cipla | 6 POUCH in 1 CARTON (69097-319-87) / 5 AM... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 76282-0641-38 | Budesonide Inhalation Suspension .5 mg/2mL INHALANT | Exelan | 6 POUCH in 1 CARTON (76282-641-38) / 5 AM... | .5 mg/2mL | 30 | $32.76 | $0.676 | ● Active | CMS + PDAC |
| 59651-0585-30 | BUDESONIDE .5 mg/2mL SUSPENSION | Aurobindo | 6 POUCH in 1 CARTON (59651-585-30) / 5 AM... | .5 mg/2mL | 0.5 | $0.55 | $0.676 | ● Active | PDAC |
| 00093-6815-55 | Budesonide .25 mg/2mL SUSPENSION | Teva | 30 POUCH in 1 CARTON (0093-6815-55) / 1 V... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 00093-6815-73 | Budesonide .25 mg/2mL SUSPENSION | Teva | 6 POUCH in 1 CARTON (0093-6815-73) / 5 VI... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 00115-1687-74 | Budesonide Inhalation .25 mg/2mL SUSPENSION | Amneal | 6 POUCH in 1 CARTON (0115-1687-74) / 5 VI... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 00487-9601-01 | Budesonide .25 mg/2mL INHALANT | Nephron | 6 POUCH in 1 CARTON (0487-9601-01) / 5 AM... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 00487-9601-30 | Budesonide .25 mg/2mL INHALANT | Nephron | 30 POUCH in 1 CARTON (0487-9601-30) / 1 A... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 47335-0631-49 | Budesonide .25 mg/2mL SUSPENSION | Sun | 6 POUCH in 1 CARTON (47335-631-49) / 5 AM... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 62135-0822-84 | Budesonide .25 mg/2mL SUSPENSION | Chartwell | 6 POUCH in 1 CARTON (62135-822-84) / 5 AM... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 64980-0638-03 | Budesonide .25 mg/2mL INHALANT | Rising | 30 POUCH in 1 CARTON (64980-638-03) / 5 A... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 69097-0318-53 | Budesonide Inhalation Suspension .25 mg/2mL INHALANT | Cipla | 30 POUCH in 1 CARTON (69097-318-53) / 1 A... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 69097-0318-87 | Budesonide Inhalation Suspension .25 mg/2mL INHALANT | Cipla | 6 POUCH in 1 CARTON (69097-318-87) / 5 AM... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 76282-0640-38 | Budesonide Inhalation Suspension .25 mg/2mL INHALANT | Exelan | 6 POUCH in 1 CARTON (76282-640-38) / 5 AM... | .25 mg/2mL | 30 | $32.76 | $0.697 | ● Active | CMS + PDAC |
| 00781-7516-87 | Budesonide .5 mg/2mL SUSPENSION | Sandoz | 6 POUCH in 1 CARTON (0781-7516-87) / 5 AM... | .5 mg/2mL | 0.5 | $0.55 | $0.730 | Obsolete | PDAC |
| 00781-7515-87 | Budesonide .25 mg/2mL SUSPENSION | Sandoz | 6 POUCH in 1 CARTON (0781-7515-87) / 5 AM... | .25 mg/2mL | 0.25 | $0.27 | $1.045 | Obsolete | PDAC |
| 00093-6817-73 | Budesonide 1 mg/2mL SUSPENSION | Teva | 6 POUCH in 1 CARTON (0093-6817-73) / 5 AM... | 1 mg/2mL | 60 | $65.52 | $3.427 | ● Active | CMS + PDAC |
| 47335-0633-49 | Budesonide 1 mg/2mL SUSPENSION | Sun | 6 POUCH in 1 CARTON (47335-633-49) / 5 AM... | 1 mg/2mL | 60 | $65.52 | $3.427 | ● Active | CMS + PDAC |
| 69097-0321-53 | Budesonide Inhalation Suspension 1 mg/2mL INHALANT | Cipla | 30 POUCH in 1 CARTON (69097-321-53) / 1 A... | 1 mg/2mL | 60 | $65.52 | $3.427 | ● Active | CMS + PDAC |
| 69097-0321-87 | Budesonide Inhalation Suspension 1 mg/2mL INHALANT | Cipla | 6 POUCH in 1 CARTON (69097-321-87) / 5 AM... | 1 mg/2mL | 60 | $65.52 | $3.427 | ● Active | CMS + PDAC |
| 00781-7517-87 | Budesonide 1 mg/2mL SUSPENSION | Sandoz | 6 POUCH in 1 CARTON (0781-7517-87) / 5 AM... | 1 mg/2mL | 1 | $1.09 | $3.531 | Obsolete | PDAC |
| 00186-1988-04 | PULMICORT RESPULES Budesonide .25 mg/2mL SUSPENSION | AstraZeneca | 6 POUCH in 1 CARTON (0186-1988-04) / 5 AM... | .25 mg/2mL | 30 | $32.76 | $4.198 | ● Active | CMS + PDAC |
| 00186-1989-04 | PULMICORT RESPULES Budesonide .5 mg/2mL SUSPENSION | AstraZeneca | 6 POUCH in 1 CARTON (0186-1989-04) / 5 AM... | .5 mg/2mL | 30 | $32.76 | $4.911 | ● Active | CMS + PDAC |
| 00186-1990-04 | PULMICORT RESPULES Budesonide 1 mg/2mL SUSPENSION | AstraZeneca | 6 POUCH in 1 CARTON (0186-1990-04) / 5 AM... | 1 mg/2mL | 60 | $65.52 | $9.845 | ● Active | CMS + PDAC |
| 16714-0019-30 | Budesonide | Northstar | — | — | 30 | $32.76 | — | — | CMS + PDAC |
| 16714-0020-30 | Budesonide | Northstar | — | — | 60 | $65.52 | — | — | CMS + PDAC |
| 50090-1467-00 | Budesonide .25 mg/2mL SUSPENSION | A-S | 30 VIAL in 1 CARTON (50090-1467-0) / 2 mL... | .25 mg/2mL | 30 | $32.76 | — | ● Active | CMS ASP |
| 50090-6586-00 | Budesonide .5 mg/2mL SUSPENSION | A-S | 6 POUCH in 1 CARTON (50090-6586-0) / 5 AM... | .5 mg/2mL | 30 | $32.76 | — | ● Active | CMS ASP |
| 50090-6590-00 | Budesonide .25 mg/2mL SUSPENSION | A-S | 6 POUCH in 1 CARTON (50090-6590-0) / 5 AM... | .25 mg/2mL | 30 | $32.76 | — | ● Active | CMS ASP |
| 50090-7126-00 | budesonide inhalation .5 mg/2mL SUSPENSION | A-S | 6 POUCH in 1 CARTON (50090-7126-0) / 10 m... | .5 mg/2mL | 30 | $32.76 | — | ● Active | CMS ASP |
| 50090-7173-00 | Budesonide .25 mg/2mL INHALANT | A-S | 30 AMPULE in 1 CARTON (50090-7173-0) / 2... | .25 mg/2mL | 30 | $32.76 | — | ● Active | CMS ASP |
| 76204-0018-01 | Budesonide | Ritedose | — | — | 30 | $32.76 | — | — | CMS + PDAC |
| 76282-0642-38 | Budesonide Inhalation Suspension 1 mg/2mL INHALANT | Exelan | 6 POUCH in 1 CARTON (76282-642-38) / 5 AM... | 1 mg/2mL | 1 | $1.09 | — | ● Active | PDAC |
| 38779-0198-04 | BUDESONIDE (MICRONIZED) | Unknown | — | — | 2,000 | $2,184.00 | — | — | PDAC |
| 16714-0018-30 | BUDESONIDE (30X2ML,SINGLE-DOSE) 0.25 MG/2 ML | Unknown | — | — | 0.25 | $0.27 | — | — | 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
$5.49M
Claims
84,831
Beneficiaries
47,308
Spend / beneficiary
$116.08
Spend / claim
$64.73
Trend by period
Where J7626 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #231 of 824
#226
KERECIS OMEGA3, PER... Q4158
$5.93M
#227
HERCESSI Q5146
$5.85M
#228
CAMCEVI J1952
$5.75M
#229
VIVIMUSTA J9056
$5.63M
#230
ORTHOVISC J7324
$5.56M
#231
BUDESONIDE* J7626
$5.49M
#232
CABENUVA J0741
$5.49M
#233
PEMRYDI RTU J9324
$5.46M
#234
STIMUFEND Q5127
$5.42M
#235
FOLOTYN* J9307
$5.4M
#236
NOVOSEVEN RT J7189
$5.33M
Total claims — #29 of 824
#24
IPRATROPIUM-ALBUTERO... J7620
105,195
#25
BOTOX COSMETIC* J0585
104,273
#26
DIPHENHYDRAMINE HCL J1200
97,723
#27
CLARISCAN* A9575
91,951
#28
ALBUTEROL SULFATE(J7... J7613
86,874
#29
BUDESONIDE* J7626
84,831
#30
DARZALEX FASPRO J9144
82,545
#31
SPIKEVAX * 91322
76,644
#32
AVASTIN J9035
74,904
#33
ELIGARD* J9217
74,331
#34
SODIUM CHLORIDE(J705... J7050
73,055
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) | $5.49M | 47,308 | 84,831 | $116.08 | $64.73 |
| 2025 (Q1-Q4) | $37.45M | 100,464 | 449,184 | $372.80 | $83.38 |
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
$38.07M
Medicare paid
$28.51M
Submitted services
30,914,297
Denial rate
5.8%
Allowed / service
$1.31
Submitted charges
$306M
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 J7626 is utilized CMS · BY PROVIDER · 2024
Medicare Part B services for this code by the rendering provider's state — 742 services across 13 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 J7626
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 2026-09-20
NDC ↔ HCPCS crosswalk
CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)
46 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.
❓ J7626 billing FAQ
What is HCPCS code J7626?
J7626 is a HCPCS Level II J-code used to bill Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J7626?
One unit of J7626 represents 0.5 MG. Report the number of units equal to the dose administered divided by 0.5 MG.
How many units of J7626 should I bill?
Divide the dose administered by the code's unit size (0.5 MG) 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 J7626?
The Medicare Part B payment limit is $1.092 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $1.070 per unit. Payment limits are revised quarterly.
Which NDCs bill under J7626?
46 NDCs currently map to J7626 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 J7626 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.