J7639
J7639 – Dornase alfa, inhalation solution, fda-approved final product, non-compo · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 2 NDCs crosswalked per 1 MG $56.780/unit ASP+6%
📋 J7639 summary
J7639 is a HCPCS Level II J-code used to bill Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administere..., billed per 1 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 J7639: Pulmozyme
Code J7639
Billing unit 1 MG Payment limit $56.780/unit NDC-Crosswalk 2
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 codeJ7639
DescriptorDornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
Billing unit1 MG
Payment limit / unit$56.780
Est. ASP / unit$53.566 est.
Mapped NDCs2
Data periodQ3 2026
Last updated2026-08-20
💊 About Dornase Alfa DRUG GUIDE
Pulmozyme (dornase alfa) is used alongside standard therapies to manage cystic fibrosis (CF) in both adults and children.
It helps improve how well the lungs work by breaking down the thick, sticky mucus that builds up in the airways of people with CF.For CF patients whose lung function is at or above 40% of the predicted normal value, daily use of Pulmozyme has also been shown to reduce the risk of serious respiratory tract infections that would require IV antibiotics.
Clinical overview from our editorial drug guide for Dornase Alfa. 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
$56.780
Est. ASP / unit
$53.566 est.
Est. after 2% sequester
$55.644
HCPCS dosage
1 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 descriptionDornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
CoverageD — Special coverage instructions apply
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 added2000-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J7639 = 1 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 J7639 LEAST EXPENSIVE FIRST
2 NDCs map to J7639. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($56.780/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 50242-0100-40 | Pulmozyme dornase alfa 1 mg/mL SOLUTION | Genentech, | 5 POUCH in 1 CARTON (50242-100-40) / 6 AM... | 1 mg/mL | 75 | $4,258.50 | $53.076 | ● Active | CMS + PDAC |
| 50242-0100-39 | PULMOZYME (AMP,INNER NDC) 2.5 MG/2.5 ML | Unknown | — | — | 1 | $56.78 | — | — | 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
$5.07M
Claims
1,187
Beneficiaries
610
Spend / beneficiary
$8,309.92
Spend / claim
$4,270.47
Trend by period
Where J7639 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #241 of 824
#236
NOVOSEVEN RT J7189
$5.33M
#237
CUTAQUIG J1551
$5.29M
#238
COSELA J1448
$5.14M
#239
AVEED J3145
$5.12M
#240
EPIFIX 1 SQ CM** Q4186
$5.1M
#241
PULMOZYME J7639
$5.07M
#242
NUWIQ J7209
$5.04M
#243
TIVDAK J9273
$4.8M
#244
LUCENTIS J2778
$4.78M
#245
GIVLAARI J0223
$4.73M
#246
VONVENDI J7179
$4.7M
Total claims — #357 of 824
#352
DEXTROSE 5%-0.9% NAC... J7042
1,276
#353
MORPHINE SULFATE(J22... J2270
1,262
#354
RIMSO-50 J1212
1,256
#355
NIKTIMVO J9038
1,223
#356
NUZYRA J0121
1,197
#357
PULMOZYME J7639
1,187
#358
BELRAPZO* J9036
1,180
#359
THYROGEN J3240
1,175
#360
ELREXFIO J1323
1,174
#361
HYDROXOCOBALAMIN J3425
1,171
#362
HEPARIN FLUSH J1642
1,162
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) | $5.07M | 610 | 1,187 | $8,309.92 | $4,270.47 |
| 2025 (Q1-Q4) | $24.53M | 900 | 5,737 | $27,255.38 | $4,275.73 |
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
$25.03M
Medicare paid
$19.53M
Submitted services
528,620
Denial rate
12.9%
Allowed / service
$54.34
Submitted charges
$39.24M
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 J7639 is utilized
⏳
The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.
📊 What bills under J7639
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)
2 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.
❓ J7639 billing FAQ
What is HCPCS code J7639?
J7639 is a HCPCS Level II J-code used to bill Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J7639?
One unit of J7639 represents 1 MG. Report the number of units equal to the dose administered divided by 1 MG.
How many units of J7639 should I bill?
Divide the dose administered by the code's unit size (1 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 J7639?
The Medicare Part B payment limit is $56.780 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $55.644 per unit. Payment limits are revised quarterly.
Which NDCs bill under J7639?
2 NDCs currently map to J7639 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 J7639 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.