HCPCS Level II · unclassified
J7195 — Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified
In short
J7195 is the HCPCS Level II code for injection, factor ix (antihemophilic factor, recombinant) per iu, 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- Descriptor
- Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified
- Short descriptor
- Factor ix recombinant nos
- Code set
- HCPCS Level II, maintained by CMS
- Effective
- Jan 1, 2015
Medicare Part B payment limit
CMS ASP fileEffective 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 J7195
CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 5 NDCs to J7195 for Benefix. Billing units per package are CMS’s figures for this code’s unit.
| Drug | NDC (11-digit) | Labeler | Package | Billing units per package |
|---|---|---|---|---|
| Benefix | 58394-0633-03 | Pfizer Inc | 1 | 1 |
| Benefix | 58394-0634-03 | Pfizer Inc | 1 | 1 |
| Benefix | 58394-0635-03 | Pfizer Inc | 1 | 1 |
| Benefix | 58394-0636-03 | Pfizer Inc | 1 | 1 |
| Benefix | 58394-0637-03 | Pfizer Inc | 1 | 1 |
J7195: common questions
- Is J7195 a CPT code?
- No. J7195 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 J7195?
- None is fixed. J7195 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 J7195?
- $1.868 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.