In short

J7192 is the HCPCS Level II code for factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified: drugs with no specific code of their own. It has no fixed drug or unit, so the claim carries the NDC of the drug given and its quantity.

Code

CMS HCPCS file
HCPCS codeJ7192
Billing unitSee descriptor
Descriptor
Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified
Short descriptor
Factor viii recombinant nos
Code set
HCPCS Level II, maintained by CMS
Effective
Jan 1, 2010

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$1.616
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.

Enter the units to build the claim line.

NDCs billed under J7192

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 12 NDCs to J7192 for Advate and Recombinate. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J7192 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Advate00944-3045-10Takeda Pharmaceuticals America, Inc.11
Advate00944-3046-10Takeda Pharmaceuticals America, Inc.11
Advate00944-3047-10Takeda Pharmaceuticals America, Inc.11
Advate00944-3051-02Takeda Pharmaceuticals America, Inc.11
Advate00944-3052-02Takeda Pharmaceuticals America, Inc.11
Advate00944-3053-02Takeda Pharmaceuticals America, Inc.11
Advate00944-3054-02Takeda Pharmaceuticals America, Inc.11
Recombinate00944-2841-10Takeda Pharmaceuticals America, Inc.11
Recombinate00944-2842-10Takeda Pharmaceuticals America, Inc.11
Recombinate00944-2843-10Takeda Pharmaceuticals America, Inc.11
Recombinate00944-2844-10Takeda Pharmaceuticals America, Inc.11
Recombinate00944-2845-10Takeda Pharmaceuticals America, Inc.11

J7192: common questions

Is J7192 a CPT code?
No. J7192 is a HCPCS Level II code, maintained by CMS, that identifies a drug with no specific code of its own. 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 NDC goes with J7192?
None is fixed. J7192 is used for drugs that have no specific HCPCS code, so the claim carries the NDC of the drug actually given and its quantity, and payers usually also ask for the drug name and dose. How to find a J-code.
What is the Medicare payment limit for J7192?
$1.616 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.

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