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See a sample rate comparisonHCPCS J7200 (Rixubis) 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.
Injection, factor IX, (antihemophilic factor, recombinant), Rixubis, per IU
| 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 J7200 |
| Medicare Payment Limit | $1.69  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J7200 by major payers:
$1.73
$1.72
$1.78
$1.79
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HCPCS J7200
5 of 25 sample ratesHigher to lower in this preview
University Of California San Francisco Medical Center, Ucsf Medical Center
$3.93Published rateForsyth Memorial Hospital, Inc., Novant Health Forsyth Medical Center
Forsyth Memorial Hospital Inc
$1.66Published rateCommunity Memorial Hospital Of Menomonee Falls Inc, Froedtert Menomonee Falls Hospital
St Josephs Community Hospital Of West Bend Inc
$1.66Published rateNassau Health Care Corporation, Numc Department Of Ob/Gyn, Fpp
$1.64Published rateAhmed Amer
New York City Health And Hospitals Corporation
$1.10Published rate
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See a sample payer proposalHCPCS J7200 vs. Other Clotting Factors Codes
The HCPCS J7200 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 J7200 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 |
|---|---|---|
| J7199-HCPCS | Moderate | Hemophilia clotting factor, not otherwise classified |
| J7200-HCPCS | Low | Injection, factor IX, (antihemophilic factor, recombinant), Rixubis, per IU |
| J7201-HCPCS | Low | Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7200 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.
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