J7203
J7203 – Injection factor ix, (antihemophilic factor, recombinant), glycopegylate · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 4 NDCs crosswalked per 1 IU $4.674/unit ASP+6%
📋 J7203 summary
J7203 is a HCPCS Level II J-code used to bill factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 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 J7203: Rebinyn
Code J7203
Billing unit 1 IU Payment limit $4.674/unit NDC-Crosswalk 4
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 codeJ7203
DescriptorInjection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu
Billing unit1 IU
Payment limit / unit$4.674
Est. ASP / unit$4.409 est.
Mapped NDCs4
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
$4.674
Est. ASP / unit
$4.409 est.
Est. after 2% sequester
$4.581
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 ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu
CoverageD — Special coverage instructions apply
Pricing indicator51 — Drug — priced under the ASP methodology
Type of service1 — Medical care
BETOS-2O1E
ASC payment groupYY
Action codeN — No maintenance this year
Effective date2019-01-01
Date added2019-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J7203 = 1 iu. Enter a regimen to convert dose → billing units and project a full course.
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 J7203 WITH EST. MEDICARE PAY
4 NDCs map to J7203. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($4.674/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 00169-7901-01 | REBINYN coagulation factor IX recombinant, GlycoPEGylated KIT | Novo | 1 KIT in 1 KIT (0169-7901-01) * 4 mL in... | — | 1 | $4.67 | — | ● Active | CMS ASP |
| 00169-7902-01 | REBINYN coagulation factor IX recombinant, GlycoPEGylated KIT | Novo | 1 KIT in 1 KIT (0169-7902-01) * 4 mL in... | — | 1 | $4.67 | — | ● Active | CMS ASP |
| 00169-7903-01 | REBINYN coagulation factor IX recombinant, GlycoPEGylated KIT | Novo | 1 KIT in 1 KIT (0169-7903-01) * 4 mL in... | — | 1 | $4.67 | — | ● Active | CMS ASP |
| 00169-7905-01 | REBINYN coagulation factor IX recombinant, GlycoPEGylated KIT | Novo | 1 KIT in 1 KIT (0169-7905-01) * 4 mL in... | — | 1 | $4.67 | — | ● 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.
📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)
Period
Total Part B spend
$1.03M
Claims
22
Beneficiaries
—
Spend / beneficiary
—
Spend / claim
$46,925.41
Trend by period
Where J7203 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #377 of 824
#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
#378
RAMPART DL MATRIX PE... Q4347
$1.02M
#379
INVEGA HAFYERA* J2427
$1.02M
#380
RELESE, PER SQ CM** Q4257
$1.01M
#381
ELAPRASE J1743
$1M
#382
ACESSO TL, PER SQ CM... Q4300
$992.4K
Total claims — #777 of 824
#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
#782
SIGNIFOR LAR J2502
21
Top Medicare Part B drugs by the selected metric. Click any drug to open its J-code page. Source: CMS Medicare Quarterly Part B Spending by Drug.
Full breakdown by period (2)
| Period | Total spend | Beneficiaries | Claims | $/beneficiary | $/claim |
|---|---|---|---|---|---|
| 2026 (Q1) | $1.03M | — | 22 | — | $46,925.41 |
| 2025 (Q1-Q4) | $4.02M | 19 | 94 | $211,610.72 | $42,772.38 |
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
$2.46M
Medicare paid
$2.19M
Submitted services
579,820
Denial rate
3.2%
Allowed / service
$4.38
Submitted charges
$4.22M
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 J7203 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
4 NDCs 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.
❓ J7203 billing FAQ
What is HCPCS code J7203?
J7203 is a HCPCS Level II J-code used to bill Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J7203?
One unit of J7203 represents 1 IU. Report the number of units equal to the dose administered divided by 1 IU.
How many units of J7203 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 J7203?
The Medicare Part B payment limit is $4.674 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $4.581 per unit. Payment limits are revised quarterly.
Which NDCs bill under J7203?
4 NDCs currently map to J7203 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 J7203 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.
For professional billing reference only — verify against the current CMS files before submitting claims.