Home Drug Codes J Codes J7186 · ALPHANATE
Updated July 1st, 2026

ALPHANATE J Code: J7186

Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.

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Q4 2026 Medicare Payment Limit for J7186, effective October 1, 2026: $1.267 per HCPCS billing unit, down 0.2% from $1.269. From CMS's final file.

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Medicare Payment Limit ?
$1.269
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$1.269
/ HCPCS billing unit · APC 1213
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
10
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Drug & Product Overview

HCPCS Descriptor Injection, antihemophilic factor viii/von willebrand factor complex (human), per factor viii i.u.
HCPCS Added Date January 1, 2009
Manufacturer Grifols
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Kit | Not Available

About ALPHANATE

Alphanate is a medication aligned to the HCPCS J Code: J7186 for billing, pricing, and reimbursement purposes in the United States. It is a Hematology drug administered via the intravenous route and manufactured by Grifols.

According to CMS Drug Use Information: This product contains human factor VIII (also called antihemophilic factor) and von Willebrand factor complex. Factors are proteins normally found in the blood that help the blood to thicken (clot) and stop any bleeding. People with low levels of factor VIII and von Willebrand factor are at risk for bleeding longer after an injury/surgery and for bleeding inside the body (especially into the joints and muscles). This product is used to temporarily replace the missing factors and reduce bleeding. Different brands of this product have different amounts of these factors, and so have different uses. These products are not interchangeable. Do not change brands of this medication without the approval of your doctor. Some products are used to control and prevent bleeding episodes in people with low levels of factor VIII (hemophilia A). Some products are used to control and prevent bleeding episodes in people with low levels of von Willebrand factor (von Willebrand disease). Some products are used to prevent excessive bleeding during and after surgery in patients with von Willebrand disease.

Disclaimer: This is a summary and does not contain all possible information about this product. For complete information about this product or your specific health needs, ask your healthcare professional.

NDC Code Information

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ALPHANATE Pricing & Reimbursement

J7186 Private Payer Reimbursement
$1.18 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

Historical Graphing and Billing Calculator

per HCPCS unit
As of Q3 2026

ALPHANATE CPT Administration Codes

The below list of CPT codes is intended for informational purposes only and may not be exhaustive. CPT® codes and descriptions are copyright American Medical Association (AMA). All rights reserved.

CPT Code Description
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); initial, up to 1 hour
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or drug); each additional hour (List separately in addition to code for primary procedure)
JW / JZ modifiers apply

CMS has identified Alphanate (J7186) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ALPHANATE Medically Unlikely Edits (MUE)

The most billing units of J7186 Medicare will pay for one patient in one day, as published by CMS. 1 unit = per factor viii iu. The limit is different in the office and the hospital. Use the one for your setting.

Practitioner Office
7,500 units / day
Physician office · clinic
Hospital Outpatient
9,600 units / day
Outpatient hospital · OPPS

MAI 1 · Line Edit. Per-line limit: units are checked per claim line; medically necessary units beyond the limit may be billable on separate lines with appropriate modifiers. See all MUE limits →

ALPHANATE Clinical Information

Indications and drug classification.

Treated Diseases & Conditions

This list of indications is not exhaustive and may be subject to errors. The information on BuyandBill.com is intended for informational purposes only and should not be used for medical advice.

Hemophilia A von Willebrand disease

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Frequently Asked Questions

Is there an available Alphanate billing and coding guide?
Billing and coding information for ALPHANATE can be found through Grifols. Visit Here →
Are there any available Alphanate patient assistance programs?
ALPHANATE patient assistance information can be found through Grifols. Visit Here →
Where can I find Alphanate prescribing information?
Our team is still working to identify a prescribing information source for ALPHANATE
Where can I find Alphanate side effect information?
Our team has not yet identified a source of side effects information for ALPHANATE. Please check back in a few weeks.
Does billing ALPHANATE require JZ/JW wastage modifiers?
CMS has identified ALPHANATE(J7186) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. See CMS guidelines on use of the JZ and JW wastage modifiers below.

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