Home Drug Codes J Codes J7201 · ALPROLIX
Updated July 1st, 2026

ALPROLIX J Code: J7201

Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.

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Q4 2026 Medicare Payment Limit for J7201, effective October 1, 2026: $3.761 per HCPCS billing unit, up 1.3% from $3.711. From CMS's final file.

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Medicare Payment Limit ?
$3.711
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$3.711
/ HCPCS billing unit · APC 1486
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
6
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Drug & Product Overview

HCPCS Descriptor Injection, factor ix, fc fusion protein, (recombinant), alprolix, 1 i.u.
HCPCS Added Date January 1, 2015
Manufacturer Bioverativ Therapeutics
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Kit

About ALPROLIX

Alprolix is a medication aligned to the HCPCS J Code: J7201 for billing, pricing, and reimbursement purposes in the United States. It is a Hematology drug administered via the intravenous route and manufactured by Bioverativ Therapeutics.

According to CMS Drug Use Information: This medication is used to prevent or control bleeding in people with little or no factor IX (due to hemophilia B, Christmas disease). Factor IX is a protein (clotting factor) in the blood that works with other clotting factors to help the blood clot and stop bleeding. People with little or no factor IX are at risk for bleeding longer after an injury/surgery or bleeding suddenly (often in the joints/muscle) without an obvious cause. This medication should not be used to treat other types of factor deficiencies (such as factors II, VII, VIII, X) or factor problems (such as inhibitor to factor XIII), to reverse the effects of "blood thinners" (such as warfarin), or to treat bleeding from low levels of liver-dependent clotting factors (due to liver problems).

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

Based on publicly available CMS files. Showing 5 of 6 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
71104-0911-01 Alprolix Bioverativ Therapeutics Inc. 1 Kit
71104-0922-01 Alprolix Bioverativ Therapeutics Inc. 1 Kit
71104-0933-01 Alprolix Bioverativ Therapeutics Inc. 1 Kit
71104-0944-01 Alprolix Bioverativ Therapeutics Inc. 1 Kit
71104-0966-01 Alprolix Bioverativ Therapeutics Inc. 1 Kit
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ALPROLIX Pricing & Reimbursement

J7201 Private Payer Reimbursement
$3.46 / 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

ALPROLIX 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 Alprolix (J7201) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ALPROLIX Medically Unlikely Edits (MUE)

The most billing units of J7201 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 iu.

Practitioner Office & Hospital Outpatient
9,000 units / day
= 9,000 iu per day

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 →

iu Enter a dose to see how many billing units it is and whether it is under the limit.

ALPROLIX 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 B

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Frequently Asked Questions

Is there an available Alprolix billing and coding guide?
Billing and coding information for ALPROLIX can be found through Bioverativ Therapeutics. Visit Here →
Are there any available Alprolix patient assistance programs?
ALPROLIX patient assistance information can be found through Bioverativ. Visit Here →
Where can I find Alprolix prescribing information?
ALPROLIX prescribing information can be found at the link below: Visit Here →
Where can I find Alprolix side effect information?
Our team has not yet identified a source of side effects information for ALPROLIX. Please check back in a few weeks.
Does billing ALPROLIX require JZ/JW wastage modifiers?
CMS has identified ALPROLIX(J7201) 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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