J7214 HCPCS code: Injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.
J7214 is the HCPCS Level II code for injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.. In 2024 Medicare paid an average of $4.19 per service for J7214 across 13,455,044 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 9600 per day on outpatient hospital claims. Medicare volume rose 593% from 2023 to 2024 (1,941,302 to 13,455,044 services). In 2024, about 77 clinicians billed Medicare for J7214 for 134 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2023-10-01 |
| Last action effective | 2023-10-01 |
Who bills J7214 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 77 |
| Medicare beneficiaries | 134 |
| States with claims | 3 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J7214, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 1,941,302 | 47 | $5.45 | $4.34 |
| 2024 | 13,455,044 | 134 | $5.26 | $4.19 |
States with the most J7214 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 4,065,309 | $3.66 |
| Pennsylvania | 1,378,539 | $3.66 |
| Indiana | 1,329,314 | $3.56 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 9600 | Clinical: CMS Workgroup |
| practitioner claims | 7500 | Clinical: CMS Workgroup |
What changed for J7214
- 2023-10-01: J7214 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J7214?
J7214 is the HCPCS Level II code for injection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.. Short descriptor: "Altuviiio per factor viii iu".
How much does Medicare pay for J7214?
In 2024, the average Medicare payment was $4.19 per service (average allowed $5.26).
Does Medicare cover J7214?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
How many units of J7214 can be billed per day?
9600 on outpatient hospital claims; 7500 on practitioner claims (NCCI medically unlikely edits).
Related J72 codes
- J7200 — Injection, factor ix, (antihemophilic factor, recombinant), rixubis, per iu
- J7201 — Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.
- J7202 — Injection, factor ix, albumin fusion protein, (recombinant), idelvion, 1 i.u.
- J7203 — Injection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iu
- J7204 — Injection, factor viii, antihemophilic factor (recombinant), (esperoct), glycopegylated-exei, per iu
- J7205 — Injection, factor viii fc fusion protein (recombinant), per iu
- J7207 — Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.
- J7208 — Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.
- J7209 — Injection, factor viii, (antihemophilic factor, recombinant), (nuwiq), 1 i.u.
- J7210 — Injection, factor viii, (antihemophilic factor, recombinant), (afstyla), 1 i.u.
- J7211 — Injection, factor viii, (antihemophilic factor, recombinant), (kovaltry), 1 i.u.
- J7212 — Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram
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Next steps
- Run a reimbursement report for a device billed under J7214
- Watch J7214 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J7214
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.