J7212
J7212 – Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 mic · NDC Crosswalk & Billing Units
HCPCS Level II J-code · Medicare Part B drug billing
J-code
● 3 NDCs crosswalked per 1 MCG $2.194/unit ASP+6%
📋 J7212 summary
J7212 is a HCPCS Level II J-code used to bill Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram, billed per 1 MCG. 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 J7212: Sevenfact
Code J7212
Billing unit 1 MCG Payment limit $2.194/unit NDC-Crosswalk 3
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 codeJ7212
DescriptorFactor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram
Billing unit1 MCG
Payment limit / unit$2.194
Est. ASP / unit$2.070 est.
Mapped NDCs3
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
$2.194
Est. ASP / unit
$2.070 est.
Est. after 2% sequester
$2.150
HCPCS dosage
1 MCG
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 descriptionFactor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram
CoverageC — Carrier/MAC judgment
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 date2021-01-01
Date added2021-01-01
Source: CMS HCPCS Level II code file (imported via admin).
🧮 Dosing & billing-units calculator HCPCS UNITS
One billing unit of J7212 = 1 mcg. 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 J7212 WITH EST. MEDICARE PAY
3 NDCs map to J7212. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($2.194/unit) × that package's bill units.
| NDC (11-digit) | Drug | Labeler | Package | Strength | Bill units | Est. pay / pkg | NADAC / unit | Status | Source |
|---|---|---|---|---|---|---|---|---|---|
| 71127-1000-01 | Sevenfact Coagulation Factor VIIa Recombinant Human KIT | Laboratoire | 1 KIT in 1 PACKAGE (71127-1000-1) * 1 mL... | — | 1,000 | $2,194.00 | — | ● Active | CMS ASP |
| 71127-2000-01 | Sevenfact Coagulation Factor VIIa Recombinant Human KIT | Laboratoire | 1 KIT in 1 PACKAGE (71127-2000-1) * 2 mL... | — | 2,000 | $4,388.00 | — | ● Active | CMS ASP |
| 71127-5000-01 | Sevenfact Coagulation Factor VIIa Recombinant Human KIT | Laboratoire | 1 KIT in 1 PACKAGE (71127-5000-1) * 5 mL... | — | 5,000 | $10,970.00 | — | ● 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
$7.11M
Claims
87
Beneficiaries
—
Spend / beneficiary
—
Spend / claim
$81,693.40
Trend by period
Where J7212 ranks among Part B drugs · 2026 (Q1) · neighbors ±5
Total spending — #210 of 824
#205
ZYNLONTA J9359
$7.38M
#206
TRIESENCE J3300
$7.37M
#207
EMRELIS J9326
$7.18M
#208
PEMFEXY J9304
$7.15M
#209
JELMYTO J9281
$7.14M
#210
SEVENFACT J7212
$7.11M
#211
FYLNETRA Q5130
$6.83M
#212
YONDELIS J9352
$6.7M
#213
IMLYGIC J9325
$6.54M
#214
ISTODAX* J9319
$6.53M
#215
DUOPA J7340
$6.53M
Total claims — #644 of 824
#639
ELFABRIO J2508
94
#640
OMVOH PEN* J2267
90
#641
BREYANZI Q2054
89
#642
BUTORPHANOL TARTRATE J0595
88
#643
CYTOGAM J0850
88
#644
SEVENFACT J7212
87
#645
GEMCITABINE HCL(J919... J9196
86
#646
BKEMV Q5152
84
#647
METHOTREXATE* J8610
81
#648
PURAPLY 1 SQ CM** Q4195
80
#649
XWRAP 1 SQ CM** Q4204
80
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) | $7.11M | — | 87 | — | $81,693.40 |
| 2025 (Q1-Q4) | $28.71M | — | 336 | — | $85,451.05 |
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
$29.18M
Medicare paid
$22.88M
Submitted services
12,290,836
Denial rate
0.3%
Allowed / service
$2.38
Submitted charges
$30.03M
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.
🗃️ 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
3 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.
❓ J7212 billing FAQ
What is HCPCS code J7212?
J7212 is a HCPCS Level II J-code used to bill Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram under Medicare Part B and most medical (not pharmacy) benefits.
What is the billing unit for J7212?
One unit of J7212 represents 1 MCG. Report the number of units equal to the dose administered divided by 1 MCG.
How many units of J7212 should I bill?
Divide the dose administered by the code's unit size (1 MCG) 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 J7212?
The Medicare Part B payment limit is $2.194 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $2.150 per unit. Payment limits are revised quarterly.
Which NDCs bill under J7212?
3 NDCs currently map to J7212 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 J7212 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.