Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHCPCS J7189 (Novoseven Rt) Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Clotting Factors |
| Common Place of Service | None 99 - Other POS |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J7189 |
| Medicare Payment Limit | $2.655  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J7189 by major payers:
$2.93
$3.32
$2.68
$2.68
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS J7189.
HCPCS J7189
5 of 25 sample ratesHigher to lower in this preview
Guiying Hu
Kelsey-Seybold Medical Group PLLC
$7.13Published rateMaria Nguyen
Nhcs Physicians Inc
$3.31Published rateZeyar Thet
Coney Island Medical Practice Plan PC
$2.70Published rateKare Infusion Center LLC
$2.54Published rateAllison Nazinitsky
Ut Regional One Physicians Inc
$2.53Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalHCPCS J7189 vs. Other Clotting Factors Codes
The HCPCS J7189 code is part of the Drugs Administered Other than Oral Method services used for Clotting Factors. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS J7189 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| J7188-HCPCS | Low | Injection, factor VIII (antihemophilic factor, recombinant), (OBIZUR), per i.u. |
| J7189-HCPCS | Low | Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram |
| J7190-HCPCS | Low | Factor VIII (antihemophilic factor, human) per IU |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7189. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7189 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS J7189) and we'll show you how you compare in 15 minutes or less.