No. J7190 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code.

What NDCs are billed under J7190?

CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 7 NDCs under J7190, for Hemofil M and Koate. The table on this page shows each one with its billing units per package.

What is the Medicare payment limit for J7190?

$1.248 per 1 iu, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.

J7190 J-Code: Hemofil M, Koate

In short

J7190 is the HCPCS Level II code for factor viii (antihemophilic factor, human) per i.u. CMS assigns NDCs for Hemofil M and Koate to it. The Medicare Part B payment limit is $1.248 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file

HCPCS codeJ7190

Billing unitSee descriptor

Descriptor: Factor viii (antihemophilic factor, human) per i.u.
Short descriptor: Factor viii
Code set: HCPCS Level II, maintained by CMS
Effective: Jan 1, 1999

Medicare Part B payment limit

CMS ASP file

Payment limit per unit$1.248

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

Units and claim line

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

HCPCS units

Modifier

NDC (11-digit)

NDC unit qualifier

NDC quantity

Enter the units to build the claim line.

NDCs billed under J7190

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 7 NDCs to J7190 for Hemofil M and Koate. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J7190 in the CMS ASP crosswalk
Drug	NDC (11-digit)	Labeler	Package	Billing units per package
Hemofil M	00944-3940-02	Takeda Pharmaceuticals America, Inc.	1	1
Hemofil M	00944-3942-02	Takeda Pharmaceuticals America, Inc.	1	1
Hemofil M	00944-3944-02	Takeda Pharmaceuticals America, Inc.	1	1
Hemofil M	00944-3946-02	Takeda Pharmaceuticals America, Inc.	1	1
Koate	76125-0257-25	Kedrion Biopharma Inc	1	1
Koate	76125-0663-50	Kedrion Biopharma Inc	1	1
Koate	76125-0679-12	Kedrion Biopharma Inc	1	1

J7190: common questions

Is J7190 a CPT code?: No. J7190 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under J7190?: CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 7 NDCs under J7190, for Hemofil M and Koate. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J7190?: $1.248 per 1 iu, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.

J7190 — Factor viii (antihemophilic factor, human) per i.u.