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See a sample rate comparisonHCPCS J7207 (Adynovate) 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 viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.
| 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 J7207 |
| Medicare Payment Limit | $2.097  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J7207 by major payers:
$2.16
$2.17
$2.30
$2.25
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HCPCS J7207
5 of 25 sample ratesHigher to lower in this preview
Riverside Middle Peninsula Hospital Inc, Riverside Walter Reed Hospital
Riverside Healthcare Association Inc
$5.38Published rateSt. Mary'S Health, Inc., Ascension St. Vincent Evansville
United States Catholic Conference
$2.23Published rateDallas County Hospital District, Parkland Health
Dallas County Hospital District
$2.09Published rateHancock Regional Hospital, Hancock Regional Hospital
Hancock Regional Hospital
$2.09Published rateNew York City Health And Hospitals Corporation, Woodhull Medical & Mental Health Center
New York City Health And Hospitals Corporation
$1.38Published rate
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See a sample payer proposalHCPCS J7207 vs. Other Clotting Factors Codes
The HCPCS J7207 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 J7207 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 |
|---|---|---|
| J7205-HCPCS | Low | Injection, factor VIII Fc fusion protein (recombinant), per IU |
| J7207-HCPCS | Low | Injection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u. |
| J7208-HCPCS | Low | Injection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 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 J7207. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7207 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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