HEMLIBRA J Code: J7170

Drug & Product Overview

HCPCS Descriptor Injection, emicizumab-kxwh, 0.5 mg

HCPCS Added Date January 1, 2019

Manufacturer Genentech

Route of Administration Subcutaneous

Generic Status Single-Source; Branded

Dosage Type Single-Dose

Dosage Form Injection, Solution

About HEMLIBRA

Hemlibra is a medication aligned to the HCPCS J Code: J7170 for billing, pricing, and reimbursement purposes in the United States. This Hematology medication is administered via the subcutaneous route and manufactured by Genentech.

According to CMS Drug Use Information: This medication is used by people with a certain inherited bleeding problem (hemophilia A) to help prevent or lessen how often you have bleeding problems. Emicizumab belongs to a class of medications known as monoclonal antibodies. It works by helping your blood to clot normally, which helps prevent bleeding due to hemophilia A. Preventing bleeding can lessen symptoms such as painful swellings, joint pain, pain with movement, and difficulty walking far.

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
50242-0920-01	Hemlibra	Genentech, Inc.	60	30 MG / 1 ML
50242-0921-01	Hemlibra	Genentech, Inc.	120	60 MG / 0.4 ML
50242-0922-01	Hemlibra	Genentech, Inc.	210	105 MG / 0.7 ML
50242-0923-01	Hemlibra	Genentech, Inc.	300	150 MG / 1 ML
50242-0927-01	Hemlibra	Genentech, Inc.	24	12 MG / 0.4 ML
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HEMLIBRA Pricing & Reimbursement

J7170 Private Payer Reimbursement

$56.35 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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Historical Graphing and Billing Calculator

per HCPCS unit

As of Q3 2026

HEMLIBRA CPT Administration Codes

CPT Code	Description
96372	Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular

JW / JZ modifiers apply

CMS has identified Hemlibra (J7170) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

HEMLIBRA Medically Unlikely Edits (MUE)

The most billing units of J7170 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.5 mg.

Practitioner Office & Hospital Outpatient

1,800 units / day

= 900 mg per day

MAI 3 · Date of Service Edit: Clinical. Per-day limit based on clinical expectations; excess units are denied but may be appealed with documentation of medical necessity. See all MUE limits →

HEMLIBRA 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) with or without factor VIII inhibitors

Frequently Asked Questions

Is there an available Hemlibra billing and coding guide?

Billing and coding information for HEMLIBRA can be found through Genentech. Visit Here →

Are there any available Hemlibra patient assistance programs?

HEMLIBRA patient assistance information can be found through Genentech. Visit Here →

Where can I find Hemlibra prescribing information?

HEMLIBRA prescribing information can be found at the link below: Visit Here →

Where can I find Hemlibra side effect information?

Information regarding HEMLIBRA's side effects can be found at MedlinePlus Visit Here →

Does billing HEMLIBRA require JZ/JW wastage modifiers?

CMS has identified HEMLIBRA(J7170) 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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