In short

J7194 is the HCPCS Level II code for factor ix, complex, per i.u. CMS assigns NDCs for Profilnine to it. The Medicare Part B payment limit is $1.748 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ7194
Billing unitSee descriptor
Descriptor
Factor ix, complex, per i.u.
Short descriptor
Factor ix complex
Code set
HCPCS Level II, maintained by CMS
Effective
Jan 1, 1998

Medicare Part B payment limit

CMS ASP file
Payment 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

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 J7194

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 3 NDCs to J7194 for Profilnine. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J7194 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Profilnine68516-3210-01Grifols USA, LLC11
Profilnine68516-3211-02Grifols USA, LLC11
Profilnine68516-3212-02Grifols USA, LLC11

J7194: common questions

Is J7194 a CPT code?
No. J7194 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 J7194?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 3 NDCs under J7194, for Profilnine. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J7194?
$1.748 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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