Home Drug Codes J Codes J7168 · KCENTRA
Updated July 1st, 2026

KCENTRA J Code: J7168

Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity

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Medicare Payment Limit ?
Not published
CMS publishes none for Q3 2026
APC Payment Limit ?
$2.012
/ HCPCS billing unit · APC 9132
ASP ?
No current ASP
Not available for Q3 2026
WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
2
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Drug & Product Overview

HCPCS Descriptor Prothrombin complex concentrate (human), kcentra, per i.u. of factor ix activity
HCPCS Added Date July 1, 2021
Manufacturer CSL Behring
Route of Administration Multiple Routes
Generic Status Single-Source; Branded
Dosage Type Single-Dose
Dosage Form Kit

About KCENTRA

Kcentra is a medication aligned to the HCPCS J Code: J7168 for billing, pricing, and reimbursement purposes in the United States. It is a Hematology drug administered via the multiple routes route and manufactured by CSL Behring.

Manufacturers, reach out to us to add more information.

NDC Code Information

2 NDC packages are crosswalked to J7168. Package detail is available to logged-in subscribers.

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KCENTRA Pricing & Reimbursement

J7168 Private Payer Reimbursement
$2.77 / HCPCS unit as of Jan 2026

National median reimbursement across major commercial payers.

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UnitedHealthcare, BlueCross BlueShield, Aetna, Cigna

KCENTRA 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 Kcentra (J7168) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

KCENTRA Medically Unlikely Edits (MUE)

The most billing units of J7168 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 iu.

Practitioner Office & Hospital Outpatient
5,000 units / day
= 5,000 iu 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 →

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

KCENTRA 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.

Acquired coagulation factor deficiency induced by Vitamin K antagonist (VKA) therapy with acute major bleeding or need for urgent surgery/invasive procedure

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Frequently Asked Questions

Is there an available Kcentra billing and coding guide?
Billing and coding information for KCENTRA can be found through CSL Behring. Visit Here →
Are there any available Kcentra patient assistance programs?
KCENTRA patient assistance information can be found through CSL Behring. Visit Here →
Where can I find Kcentra prescribing information?
KCENTRA prescribing information can be found at the link below: Visit Here →
Where can I find Kcentra side effect information?
Our team has not yet identified a source of side effects information for KCENTRA. Please check back in a few weeks.
Does billing KCENTRA require JZ/JW wastage modifiers?
CMS has identified KCENTRA(J7168) 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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