Home Drug Codes J Codes J7205 · ELOCTATE
Updated July 1st, 2026

ELOCTATE J Code: J7205

Injection, factor viii fc fusion protein (recombinant), per iu

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Q4 2026 Medicare Payment Limit for J7205, effective October 1, 2026: $2.557 per HCPCS billing unit, down 0.8% from $2.578. From CMS's final file.

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Medicare Payment Limit ?
$2.578
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$2.578
/ HCPCS billing unit · APC 1656
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
10
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Drug & Product Overview

HCPCS Descriptor Injection, factor viii fc fusion protein (recombinant), per iu
HCPCS Added Date January 1, 2016
Manufacturer Bioverativ Therapeutics
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Kit

About ELOCTATE

Eloctate is a medication aligned to the HCPCS J Code: J7205 for billing, pricing, and reimbursement purposes in the United States. Classified under Hematology, it is administered via the intravenous route and manufactured by Bioverativ Therapeutics.

According to CMS Drug Use Information: This medication is used to control and prevent bleeding that happens to people (usually males) with an inherited medical condition, hemophilia A (low levels of factor VIII). It is also given before surgery to prevent too much bleeding in people with this condition. Factor VIII is a protein (clotting factor) that is in normal blood, and helps form blood clots and stop bleeding after an injury. People with low factor VIII levels may bleed longer than normal after an injury/surgery and may have bleeding inside the body (especially in the joints and muscles). This medication contains man-made factor VIII (antihemophilic factor) to temporarily replace factor VIII in the body, connected to an antibody (immunoglobulin) that helps the man-made factor VIII work longer. When used to control and prevent bleeding, this medication may help relieve pain and long-term damage caused by hemophilia A. This medication should not be used to treat 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

Based on publicly available CMS files. Showing 5 of 10 NDCs — log in for the full crosswalk.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
71104-0801-01 Eloctate Bioverativ Therapeutics Inc. 1 Kit
71104-0802-01 Eloctate Bioverativ Therapeutics Inc. 1 Kit
71104-0803-01 Eloctate Bioverativ Therapeutics Inc. 1 Kit
71104-0804-01 Eloctate Bioverativ Therapeutics Inc. 1 Kit
71104-0805-01 Eloctate Bioverativ Therapeutics Inc. 1 Kit
•••••-••••-•• Log in to view ELOCTATE
ELOCTATE
ELOCTATE
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ELOCTATE Pricing & Reimbursement

J7205 Private Payer Reimbursement
$2.35 / 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

ELOCTATE 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 Eloctate (J7205) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

ELOCTATE Medically Unlikely Edits (MUE)

The most billing units of J7205 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 iu.

Practitioner Office & Hospital Outpatient
9,750 units / day
= 9,750 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.

ELOCTATE 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 (congenital Factor VIII deficiency)

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Frequently Asked Questions

Is there an available Eloctate billing and coding guide?
Our team has not identified a manufacturer-published source of billing and coding information for ELOCTATE.
Are there any available Eloctate patient assistance programs?
ELOCTATE patient assistance information can be found through Bioverativ. Visit Here →
Where can I find Eloctate prescribing information?
ELOCTATE prescribing information can be found at the link below: Visit Here →
Where can I find Eloctate side effect information?
Our team has not yet identified a source of side effects information for ELOCTATE. Please check back in a few weeks.
Does billing ELOCTATE require JZ/JW wastage modifiers?
CMS has identified ELOCTATE(J7205) 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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