J7188 — Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.
J7188 is a HCPCS Level II code for injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of J7188 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 22000 units MAI 1 — Line Edit · Clinical: CMS Workgroup
- outpatient
- 22000 units MAI 1 — Line Edit · Clinical: CMS Workgroup
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for J7188
- Long descriptor
- Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.
- Short descriptor
- Factor viii recomb obizur
- Added
- January 1, 2016
- BETOS
- O1E
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to J7188
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J7188 is not quite right, the correct code is very often within a few positions of it.
- J7179Injection, von willebrand factor (recombinant), (vonvendi), 1 i.u. vwf:rco
- J7180Injection, factor xiii (antihemophilic factor, human), 1 i.u.
- J7181Injection, factor xiii a-subunit, (recombinant), per iu
- J7182Injection, factor viii, (antihemophilic factor, recombinant), (novoeight), per iu
- J7183Injection, von willebrand factor complex (human), wilate, 1 i.u. vwf:rco
- J7185Injection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.
- J7186Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.
- J7187Injection, von willebrand factor complex (humate-p), per iu vwf:rco
- J7189Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram
- J7190Factor viii (antihemophilic factor, human) per i.u.
- J7191Factor viii (antihemophilic factor (porcine)), per i.u.
- J7192Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified
- J7193Factor ix (antihemophilic factor, purified, non-recombinant) per i.u.
- J7194Factor ix, complex, per i.u.
- J7195Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified
- J7196Injection, antithrombin recombinant, 50 i.u.
Questions about J7188
What is HCPCS code J7188?
J7188 is a HCPCS Level II code for injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J7188?
The CMS HCPCS file marks J7188 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is J7188 paid under the physician fee schedule?
J7188 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).