RxDoctor Payments Data

HCPCS J7613

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg

$0.05Medicare-allowed amount per service, averaged across 67,884 services
Providers submitted
$7.57

Asking price, not received

Medicare allowed
$0.05

The fee schedule figure

Medicare paid
$0.04

Balance is patient coinsurance

Providers submitted an average of $7.57 for this code and Medicare allowed $0.05151.4× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $0.04 (80%); the rest is the patient’s coinsurance and deductible.

Services
67,884

Medicare Part B, 2024

Beneficiaries
29,087
Providers billing it
840
Total allowed
$3,394

Services × allowed amount

What Medicare pays for HCPCS J7613

Across 67,884 services billed by 840 providers to 29,087 beneficiaries, Medicare allowed an average of $0.05 per service. That is 2.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills J7613

SpecialtyServicesBeneficiariesAvg allowedProviders
Pulmonary Disease33,98413,627$0.05220
Nurse Practitioner8,1733,698$0.05190
Internal Medicine6,1333,024$0.0589
Family Practice5,0992,360$0.05120
Physician Assistant4,5761,893$0.05108
Critical Care (Intensivists)3,4831,682$0.0519
Emergency Medicine2,6531,185$0.0545
Allergy/ Immunology1,948945$0.0533
Rheumatology1,112223$0.052
General Practice246178$0.046
Hospitalist198133$0.053
Pediatric Medicine15259$0.052
Sleep Medicine8438$0.051
Cardiac Surgery3030$0.041
Otolaryngology1212$0.061

J7613 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
New York9,747$0.05$0.0464
Texas8,593$0.05$0.0475
New Jersey4,461$0.05$0.0442
Maryland4,170$0.05$0.0440
Florida3,169$0.05$0.0453
Illinois3,135$0.05$0.0444
Georgia3,061$0.05$0.0432
California2,838$0.04$0.0364
Wisconsin2,689$0.05$0.0420
Pennsylvania2,663$0.05$0.0441
Alabama2,110$0.05$0.0423
Virginia2,058$0.05$0.0435
Iowa1,888$0.05$0.0416
Tennessee1,798$0.05$0.0432
Washington1,770$0.04$0.0321
North Carolina1,617$0.05$0.0421
Arizona1,425$0.04$0.0318
South Carolina1,239$0.05$0.0422
Colorado1,050$0.05$0.0421
Oklahoma986$0.05$0.0412
Louisiana919$0.05$0.0418
Massachusetts896$0.05$0.0412
Missouri810$0.05$0.0422
Connecticut621$0.05$0.0411
Michigan593$0.05$0.0416
New Hampshire553$0.05$0.041
Indiana484$0.05$0.0414
Mississippi424$0.05$0.0410
Minnesota398$0.05$0.044
Nebraska266$0.05$0.044
Utah215$0.04$0.033
Nevada212$0.04$0.033
West Virginia179$0.04$0.033
Oregon177$0.04$0.034
New Mexico124$0.05$0.043
Arkansas121$0.05$0.034
Rhode Island115$0.05$0.042
ZZ104$0.06$0.041
Delaware102$0.05$0.035
Kansas45$0.05$0.041
Hawaii35$0.04$0.031
Kentucky12$0.05$0.031
District of Columbia11$0.07$0.061

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.