J7640 — Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms
J7640 is a HCPCS Level II code for formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of J7640 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · Compounded Drug Policy
- outpatient
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · Compounded Drug Policy
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · Compounded Drug Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for J7640
- Long descriptor
- Formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms
- Short descriptor
- Formoterol comp unit
- Added
- January 1, 2006
- BETOS
- D1G
- Pricing indicator
- 00 — Not priced by Part B
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Service not separately priced by Part B — not covered, bundled into another service, or used by Part A only.
Codes adjacent to J7640
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J7640 is not quite right, the correct code is very often within a few positions of it.
- J7632Cromolyn sodium, inhalation solution, compounded product, administered through dme, unit dose form, per 10 milligrams
- J7633Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per 0.25 milligram
- J7634Budesonide, inhalation solution, compounded product, administered through dme, concentrated form, per 0.25 milligram
- J7635Atropine, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
- J7636Atropine, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7637Dexamethasone, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
- J7638Dexamethasone, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7639Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
- J7641Flunisolide, inhalation solution, compounded product, administered through dme, unit dose, per milligram
- J7642Glycopyrrolate, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
- J7643Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7644Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
- J7645Ipratropium bromide, inhalation solution, compounded product, administered through dme, unit dose form, per milligram
- J7647Isoetharine hcl, inhalation solution, compounded product, administered through dme, concentrated form, per milligram
- J7648Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, per milligram
- J7649Isoetharine hcl, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
Questions about J7640
What is HCPCS code J7640?
J7640 is a HCPCS Level II code for formoterol, inhalation solution, compounded product, administered through dme, unit dose form, 12 micrograms. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J7640?
The CMS HCPCS file marks J7640 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is J7640 paid under the physician fee schedule?
J7640 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).