HCPCS drug code · CMS crosswalk
Profilnine J-Code / HCPCS Code
In short
Profilnine is billed under HCPCS J7194 — Factor ix, complex, per i.u.. One billing unit is 1 IU. CMS's crosswalk lists 3 Profilnine NDCs under this code.
Reference
- J7194
- Factor ix, complex, per i.u.Billing unit: 1 IU
- Labelers
- Grifols USA, LLC
Medicare Part B payment limit
CMS ASP filePayment limit per unit$1.748
Per1 iu
Coinsurance20%
Effective 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
Profilnine units and claim line
Enter the dose given to get the J7194 units and the NDC line for the CMS-1500 and the 837P.
Enter the units to build the claim line.
Profilnine 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 |
|---|---|---|---|---|
| 68516-3210-01 | J7194 | Grifols USA, LLC | 1 | 1 |
| 68516-3211-02 | J7194 | Grifols USA, LLC | 1 | 1 |
| 68516-3212-02 | J7194 | Grifols USA, LLC | 1 | 1 |
Profilnine: common questions
- What is the J-code for Profilnine?
- Profilnine is billed under HCPCS J7194 — Factor ix, complex, per i.u.. One billing unit is 1 IU. CMS's crosswalk lists 3 Profilnine NDCs under this code.
- How many J7194 billing units are in a package of Profilnine?
- 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 J7194 a CPT code?
- No. J7194 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