Home › Drug Codes › J Codes › J7172 · HYMPAVZI
Updated July 1st, 2026

HYMPAVZI J Code: J7172

Injection, marstacimab-hncq, 0.5 mg

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Q4 2026 Medicare Payment Limit for J7172, effective October 1, 2026: $50.76 per HCPCS billing unit, down 0.8% from $51.191. From CMS's final file.

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Medicare Payment Limit ?
$51.191
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$51.191
/ HCPCS billing unit · APC 2064
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
1
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Drug & Product Overview

HCPCS Descriptor Injection, marstacimab-hncq, 0.5 mg
HCPCS Added Date July 1, 2025
Manufacturer Pfizer
Route of Administration Subcutaneous
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Injection, Solution

About HYMPAVZI

Hympavzi is a medication aligned to the HCPCS J Code: J7172 for billing, pricing, and reimbursement purposes in the United States. Classified under Hematology, it is administered via the subcutaneous route and manufactured by Pfizer.

According to CMS Drug Use Information: This medication is used by people with a certain inherited bleeding problem (hemophilia A or B) to help prevent or lessen how often you have bleeding problems. Marstacimab 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.

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. The list of NDCs below is not exhaustive.

NDC Code Drug Manufacturer Billing Units / Pkg Package Size
00069-2151-01 Hympavzi Pfizer Laboratories Div Pfizer Inc 300 150 MG / 1 ML
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HYMPAVZI Pricing & Reimbursement

J7172 Private Payer Reimbursement
$50.51 / 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

HYMPAVZI 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
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intramuscular
Not on the CMS JW / JZ list

This product is new and does not yet appear on the CMS list of HCPCS pertaining to single-dose containers. Wastage billing guide →

HYMPAVZI Medically Unlikely Edits (MUE)

The most billing units of J7172 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 0.5 mg.

Practitioner Office & Hospital Outpatient
600 units / day
= 300 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 →

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

HYMPAVZI 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) Hemophilia B (congenital factor IX deficiency)

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Frequently Asked Questions

Is there an available HYMPAVZI billing and coding guide?
Our team has not identified a manufacturer-published source of billing and coding information for HYMPAVZI.
Are there any available HYMPAVZI patient assistance programs?
HYMPAVZI patient assistance information can be found through Pfizer Inc.. Visit Here →
Where can I find HYMPAVZI prescribing information?
HYMPAVZI prescribing information can be found at the link below. Visit Here →
Where can I find HYMPAVZI side effect information?
Side effect information for HYMPAVZI can be found through MedlinePlus. Visit Here →
Does billing HYMPAVZI require JZ/JW wastage modifiers?
CMS does not include HYMPAVZI (J7172) on its list of HCPCS pertaining to single-dose containers. Per CMS guidelines, the JZ/JW wastage modifiers may not apply when billing J7172. For more information, visit the link below.

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Related Drug Codes

Explore billing, coding, and pricing for drugs related to HYMPAVZI.

C9304HYMPAVZIInjection, marstacimab-hncq, 0.5 mgPfizerAdded April 1, 2025J7185XYNTHAInjection, factor viii (antihemophilic factor, recombinant) (xyntha), per i.u.PfizerAdded January 1, 2010J7192ADVATEFactor viii (antihemophilic factor, recombinant) per i.u., not otherwise specifiedMultiple ManufacturersAdded January 1, 1994J7203REBINYNInjection factor ix, (antihemophilic factor, recombinant), glycopegylated, (rebinyn), 1 iuNovo NordiskAdded January 1, 2019J7205ELOCTATEInjection, factor viii fc fusion protein (recombinant), per iuBioverativ TherapeuticsAdded January 1, 2016J7207ADYNOVATEInjection, factor viii, (antihemophilic factor, recombinant), pegylated, 1 i.u.Takeda PharmaceuticalsAdded January 1, 2017J7208JIVIInjection, factor viii, (antihemophilic factor, recombinant), pegylated-aucl, (jivi), 1 i.u.Bayer PharmaceuticalAdded July 1, 2019J7214ALTUVIIIOInjection, factor viii/von willebrand factor complex, recombinant (altuviiio), per factor viii i.u.Bioverativ TherapeuticsAdded October 1, 2023C9047CABLIVIInjection, caplacizumab-yhdp, 1 mgGenzymeAdded July 1, 2019C9094ENJAYMOInj, sutimlimab-jome, 10 mgBioverativAdded July 1, 2022