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See a sample rate comparisonHCPCS J7212 (Sevenfact) Fee Schedule
Last Verified: October 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)-jncw (sevenfact), 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 J7212 |
| Medicare Payment Limit | $2.37  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J7212 by major payers:
$2.42
$2.37
$2.63
$2.45
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HCPCS J7212
5 of 25 sample ratesHigher to lower in this preview
Rockdale Medical Center Inc., Rockdale Hospital
Piedmont Rockdale Hospital Inc
$3.96Published ratePrisma Health-Upstate, Prisma Health Cancer Inst-Greer
Prisma Health-University Medical Group
$2.58Published rateGrace Medical Center, Inc., Department Of Internal Medicine
Grace Medical Center Inc
$2.34Published rateMercy Hospital Joplin, Mercy Hospital Joplin
Mercy Clinic Springfield Communities
$2.29Published rateComanche County Hospital Authority, Comanche County Memorial Hospital
$2.29Published rate
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See a sample payer proposalHCPCS J7212 vs. Other Clotting Factors Codes
The HCPCS J7212 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 J7212 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 |
|---|---|---|
| J7211-HCPCS | Low | Injection, factor VIII, (antihemophilic factor, recombinant), (kovaltry), 1 I.U. |
| J7212-HCPCS | Low | Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram |
| J7213-HCPCS | Low | Injection, coagulation factor ix (recombinant), ixinity, 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 J7212. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7212 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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