J7181 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J7181 summary

J7181 is a HCPCS Level II J-code used to bill factor xiii a-subunit, (recombinant), per iu, billed per 1 IU. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.

Brand names associated with J7181: Tretten

Code J7181 Billing unit 1 IU Payment limit $19.114/unit NDC-Crosswalk 1 Quarter Q3 2026 RxCUI Atlas Trace the drug concept →

⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.

🗂️ Key billing facts

HCPCS codeJ7181

DescriptorInjection, factor xiii a-subunit, (recombinant), per iu

Billing unit1 IU

Payment limit / unit$19.114

Est. ASP / unit$18.032 est.

Mapped NDCs1

Data periodQ3 2026

Last updated2026-08-20

🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026

📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).

Medicare payment limit / unit

$19.114

Est. ASP / unit

$18.032 est.

Est. after 2% sequester

$18.732

HCPCS dosage

1 IU

The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.

Full HCPCS code details (official CMS record)

Long descriptionInjection, factor xiii a-subunit, (recombinant), per iu

CoverageC — Carrier/MAC judgment

Pricing indicator51 — Drug — priced under the ASP methodology

Type of service1 — Medical care

BETOS-2O1E

ASC payment groupYY

Action codeP — Payment change

Effective date2024-01-01

Date added2015-01-01

Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J7181 = 1 iu. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (iu) Frequency — every days Number of doses NDC / package billed (optional)

Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.

🔁 NDCs that bill under J7181 WITH EST. MEDICARE PAY

1 NDC map to J7181. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($19.114/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
00169-7013-01	TRETTEN Coagulation Factor XIII A-Subunit (Recombinant) KIT	Novo	1 KIT in 1 KIT (0169-7013-01) * 3 mL in...	—	1	$19.11	—	● Active	CMS ASP

NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.

⚠️ Don't confuse J7181 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J7181. Billing units and payment limits differ — confirm the exact code, strength and form before billing.

Code	Descriptor	Billing unit	Payment limit / unit	How it differs from J7181
J7202	Factor ix idelvion inj	1 IU	$5.507	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J7201	Factor ix alprolix recomb	1 IU	$3.711	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J7195	Factor ix recombinant nos	1 IU	$1.864	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J7200	Factor ix recombinan rixubis	1 IU	$1.717	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J7203	Factor ix recomb gly rebinyn	1 IU	$4.674	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J7180	Factor xiii anti-hem factor	1 IU	$11.235	Related ingredient or formulation — confirm strength, form and billing unit before substituting.

Related codes matched on shared ingredient (CMS Medicare Part B Spending feed). Billing units and payment limits from the CMS ASP Pricing File. Always verify the precise HCPCS code for the product and strength administered.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period

Total Part B spend

$1.09M

Claims

22

Beneficiaries

—

Spend / beneficiary

—

Spend / claim

$49,489.04

Trend by period

Where J7181 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #372 of 824

#367 ALBUTEROL SULFATE(J7... J7613 $1.14M #368 ADZYNMA J7171 $1.14M #369 NOVAVAX COVID (EUA... 91304 $1.11M #370 ALHEMO PEN J7173 $1.11M #371 LEUCOVORIN CALCIUM J0640 $1.1M #372 TRETTEN J7181 $1.09M #373 PNEUMOVAX 23 90732 $1.09M #374 XYNTHA SOLOFUSE* J7185 $1.07M #375 DEFINITY RT* Q9957 $1.06M #376 CYTAL, PER SQUARE CE... Q4166 $1.04M #377 REBINYN J7203 $1.03M

Total claims — #776 of 824

#771 COMBOGESIC IV J0138 23 #772 CEFAZOLIN SODIUM(J06... J0688 23 #773 DAPTOMYCIN-0.9% NACL J0874 23 #774 BREVIBLOC* J1805 23 #775 DAPTOMYCIN(J0873) J0873 22 #776 TRETTEN J7181 22 #777 REBINYN J7203 22 #778 VYXEOS J9153 22 #779 ACETADOTE* J0132 21 #780 AMPHOTERICIN B J0285 21 #781 BENTYL* J0500 21

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$1.09M	—	22	—	$49,489.04
2025 (Q1-Q4)	$3.98M	—	74	—	$53,720.32

Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.

📈 Medicare Part B claims detail CMS PSPS · 2024

Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.

Allowed charges

$4.04M

Medicare paid

$3.17M

Submitted services

106,539

Denial rate

4.7%

Allowed / service

$39.80

Submitted charges

$5.94M

Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.

🗺️ Where J7181 is utilized

⏳

The geographic utilization map is building for this code — it aggregates millions of CMS Part B claim lines, then caches the result. Refresh in a moment; if it doesn’t appear, this code may have no reportable Part B utilization.

🗃️ Data sources & freshness

Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.

HCPCS code & descriptor

CMS HCPCS Level II code file

Loaded

Payment limit & billing unit

CMS Medicare Part B ASP Pricing File (quarterly)

Q3 2026 · as of 2026-08-20

NDC ↔ HCPCS crosswalk

CMS ASP NDC-HCPCS crosswalk

1 NDC mapped

NADAC acquisition cost

CMS National Average Drug Acquisition Cost (weekly)

Not available for mapped NDCs

Utilization & spend

CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners

Latest data year 2026

Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.

⚠️ Practical billing caveats

A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.

❓ J7181 billing FAQ

What is HCPCS code J7181?

J7181 is a HCPCS Level II J-code used to bill Injection, factor xiii a-subunit, (recombinant), per iu under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J7181?

One unit of J7181 represents 1 IU. Report the number of units equal to the dose administered divided by 1 IU.

How many units of J7181 should I bill?

Divide the dose administered by the code's unit size (1 IU) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.

How much does Medicare pay for J7181?

The Medicare Part B payment limit is $19.114 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $18.732 per unit. Payment limits are revised quarterly.

Which NDCs bill under J7181?

1 NDC currently map to J7181 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.

Does a crosswalk mean J7181 is covered?

No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.

J7181 – Injection, factor xiii a-subunit, (recombinant), per iu · NDC Crosswalk & Billing Units