No. J7197 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 J7197?

CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 2 NDCs under J7197, for Thrombate III. The table on this page shows each one with its billing units per package.

What is the Medicare payment limit for J7197?

$4.264 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.

J7197 J-Code: Thrombate III (antithrombin iii)

In short

J7197 is the HCPCS Level II code for antithrombin iii (human), per i.u. CMS assigns NDCs for Thrombate III to it. The Medicare Part B payment limit is $4.264 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file

HCPCS codeJ7197

Billing unitSee descriptor

Descriptor: Antithrombin iii (human), per i.u.
Short descriptor: Antithrombin iii injection
Code set: HCPCS Level II, maintained by CMS
Effective: Jan 1, 1997

Medicare Part B payment limit

CMS ASP file

Payment limit per unit$4.264

Per1 iu

Coinsurance19.759%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. CMS note: Inflation-adjusted coinsurance. 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 J7197

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 2 NDCs to J7197 for Thrombate III. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J7197 in the CMS ASP crosswalk
Drug	NDC (11-digit)	Labeler	Package	Billing units per package
Thrombate III	13533-0602-50	Grifols USA, LLC	1	1
Thrombate III	13533-0606-12	Grifols USA, LLC	1	1

J7197: common questions

Is J7197 a CPT code?: No. J7197 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 J7197?: CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 2 NDCs under J7197, for Thrombate III. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J7197?: $4.264 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.

J7197 — Antithrombin iii (human), per i.u.