Home › Drug Codes › J Codes › J7639 · PULMOZYME
Updated July 1st, 2026

PULMOZYME J Code: J7639

Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram

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Q4 2026 Medicare Payment Limit for J7639, effective October 1, 2026: $56.806 per HCPCS billing unit, unchanged from Q3 2026. From CMS's final file.

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Medicare Payment Limit ?
$56.78
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
Not published
CMS publishes none for Q3 2026
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
2
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Drug & Product Overview

HCPCS Descriptor Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram
HCPCS Added Date January 1, 2000
Manufacturer Genentech
Route of Administration Inhalation
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Solution

About PULMOZYME

Pulmozyme is a medication aligned to the HCPCS J Code: J7639 for billing, pricing, and reimbursement purposes in the United States. It is a Respiratory drug administered via the inhalation route and manufactured by Genentech.

According to CMS Drug Use Information: This medication is used to improve breathing and reduce the risk of lung infections in people with cystic fibrosis. It is used along with other treatments for this disease (such as chest physical therapy, medications, nutritional supplements). Dornase alfa is the same as a substance (DNase I enzyme) that is naturally produced by the body. It works in the airways by decreasing stickiness/thickness of mucus so that it can be cleared from the lungs more easily.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

Based on publicly available CMS files. Showing 1 of 2 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
50242-0100-40 Pulmozyme Genentech, Inc. 75 2.5 MG / 2.5 ML
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PULMOZYME Pricing & Reimbursement

J7639 Private Payer Reimbursement
$55.12 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

PULMOZYME CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction or for sputum induction for diagnostic purposes.
Not on the CMS JW / JZ list

CMS does not include Pulmozyme (J7639) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J7639. Wastage billing guide →

PULMOZYME Medically Unlikely Edits (MUE)

The most billing units of J7639 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 mg. The limit is different in the office and the hospital. Use the one for your setting.

Practitioner Office
3 units / day
= 3 mg per day
Hospital Outpatient
0 units / day
Not payable in this setting

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

mg Enter a dose to see how many billing units it is and whether it is under the limit.

PULMOZYME Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Cystic Fibrosis
Drug Class
Decreased Respiratory Secretion Viscosity [PE]Deoxyribonuclease I [CS]Recombinant Human Deoxyribonuclease 1 [EPC]Recombinant Proteins [CS]

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Frequently Asked Questions

Is there an available Pulmozyme billing and coding guide?
Billing and coding information for PULMOZYME can be found through Genentech. Visit Here →
Are there any available Pulmozyme patient assistance programs?
PULMOZYME patient assistance information can be found through Genentech. Visit Here →
Where can I find Pulmozyme prescribing information?
PULMOZYME prescribing information can be found at the link below: Visit Here →
Where can I find Pulmozyme side effect information?
Information regarding PULMOZYME's side effects can be found at MedlinePlus Visit Here →
Does billing PULMOZYME require JZ/JW wastage modifiers?
CMS does not include PULMOZYME (J7639) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J7639. For more information, visit the link below.

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