HCPCS drug code · CMS crosswalk
Esperoct J-Code / HCPCS Code
In short
Esperoct is billed under HCPCS J7204 — Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu. One billing unit is 1 IU. CMS's crosswalk lists 6 Esperoct NDCs under this code.
Reference
- J7204
- Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iuBilling unit: 1 IU
- Labelers
- Novo Nordisk, Inc
Medicare Part B payment limit
CMS ASP fileEffective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files
Esperoct units and claim line
Enter the dose given to get the J7204 units and the NDC line for the CMS-1500 and the 837P.
Enter the units to build the claim line.
Esperoct NDCs and billing units
From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.
| NDC (11-digit) | HCPCS | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| 00169-8100-01 | J7204 | Novo Nordisk, Inc | 1 | 1 |
| 00169-8150-01 | J7204 | Novo Nordisk, Inc | 1 | 1 |
| 00169-8200-01 | J7204 | Novo Nordisk, Inc | 1 | 1 |
| 00169-8300-01 | J7204 | Novo Nordisk, Inc | 1 | 1 |
| 00169-8400-01 | J7204 | Novo Nordisk, Inc | 1 | 1 |
| 00169-8500-01 | J7204 | Novo Nordisk, Inc | 1 | 1 |
Esperoct: common questions
- What is the J-code for Esperoct?
- Esperoct is billed under HCPCS J7204 — Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu. One billing unit is 1 IU. CMS's crosswalk lists 6 Esperoct NDCs under this code.
- How many J7204 billing units are in a package of Esperoct?
- CMS lists 1 billing units per package, depending on the NDC, where one unit is 1 IU. Units to report are based on the dose given, not the package.
- Is J7204 a CPT code?
- No. J7204 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.
Other codes for the same drug
- J7175Injection, factor x, (human), 1 i.u.
- J7180Injection, factor xiii (antihemophilic factor, human), 1 i.u.
- J7181Injection, factor xiii a-subunit, (recombinant), per iu
- J7182Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu
- J7185Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.
- J7188Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.
- J7189Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram
- J7190Factor viii (antihemophilic factor, human) per i.u.
- J7191Factor viii (antihemophilic factor (porcine)), per i.u.
- J7192Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified