In short

Xyntha is billed under HCPCS J7185 — Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.. One billing unit is 1 IU. CMS's crosswalk lists 9 Xyntha NDCs under this code.

J7185 code details

Reference

J7185
Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.Billing unit: 1 IU
Labelers
Pfizer Inc

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$1.369
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

Xyntha units and claim line

Enter the dose given to get the J7185 units and the NDC line for the CMS-1500 and the 837P.

Enter the units to build the claim line.

Xyntha 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.

Xyntha NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
58394-0012-01J7185Pfizer Inc11
58394-0013-01J7185Pfizer Inc11
58394-0014-01J7185Pfizer Inc11
58394-0015-01J7185Pfizer Inc11
58394-0016-03J7185Pfizer Inc11
58394-0022-03J7185Pfizer Inc11
58394-0023-03J7185Pfizer Inc11
58394-0024-03J7185Pfizer Inc11
58394-0025-03J7185Pfizer Inc11

Xyntha: common questions

What is the J-code for Xyntha?
Xyntha is billed under HCPCS J7185 — Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.. One billing unit is 1 IU. CMS's crosswalk lists 9 Xyntha NDCs under this code.
How many J7185 billing units are in a package of Xyntha?
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 J7185 a CPT code?
No. J7185 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.

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