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See a sample rate comparisonHCPCS J7213 (Ixinity) 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.
Injection, coagulation factor ix (recombinant), ixinity, 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 J7213 |
| Medicare Payment Limit | $1.913  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J7213 by major payers:
$1.91
$1.87
$1.96
$1.93
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HCPCS J7213
5 of 25 sample ratesHigher to lower in this preview
Lauren Danchak
$2.83Published rateRan Schwarzkopf
New York University
$2.32Published rateSt. Charles Hospital Corp.
St Charles Hospital Corp
$2.20Published rateChristopher Orpiano
Reedley Community Hospital
$1.82Published rateAurora Medical Center Of Oshkosh, Inc
Aurora Health Care Inc
$1.72Published rate
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See a sample payer proposalHCPCS J7213 vs. Other Clotting Factors Codes
The HCPCS J7213 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 J7213 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 |
|---|---|---|
| J7212-HCPCS | Low | Factor viia (antihemophilic factor, recombinant)-jncw (sevenfact), 1 microgram |
| J7213-HCPCS | Low | Injection, coagulation factor ix (recombinant), ixinity, 1 i.u. |
| J7294-HCPCS | High | Segesterone acetate and ethinyl estradiol 0.15mg, 0.013mg per 24 hours; yearly vaginal system, each |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7213. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J7213 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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