Home Drug Codes J Codes J7197 · THROMBATE III
Updated July 1st, 2026

THROMBATE III J Code: J7197

Antithrombin iii (human), per i.u.

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Q4 2026 Medicare Payment Limit for J7197, effective October 1, 2026: $4.264 per HCPCS billing unit, up 2.2% from $4.174. From CMS's final file.

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Medicare Payment Limit ?
$4.174
/ HCPCS billing unit · Q3 2026
APC Payment Limit ?
$4.174
/ HCPCS billing unit · APC 1263
ASP ?
$•••.••
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WAC · AWP ?
$•••.••
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NDCs Crosswalked ?
2
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Drug & Product Overview

HCPCS Descriptor Antithrombin iii (human), per i.u.
HCPCS Added Date January 1, 1992
Manufacturer Grifols
Route of Administration Intravenous
Generic Status Single-Source; Branded
Dosage Form Kit

About THROMBATE III

Thrombate III is a medication aligned to the HCPCS J Code: J7197 for billing, pricing, and reimbursement purposes in the United States. This Hematology medication is administered via the intravenous route and manufactured by Grifols.

According to CMS Drug Use Information: Drug uses not available

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
13533-0602-50 Thrombate Iii GRIFOLS USA, LLC 1 Kit
13533-0606-12 Thrombate Iii GRIFOLS USA, LLC 1 Kit
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THROMBATE III Pricing & Reimbursement

J7197 Private Payer Reimbursement
$4.05 / 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

THROMBATE III 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 Thrombate III (J7197) as a HCPCS code with single-dose containers. Therefore, the JW/JZ wastage modifiers could be required for billing purposes. Wastage billing guide →

THROMBATE III Medically Unlikely Edits (MUE)

The most billing units of J7197 Medicare will pay for one patient in one day, as published by CMS. 1 unit = 1 iu.

Practitioner Office & Hospital Outpatient
6,300 units / day
= 6,300 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.

THROMBATE III 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.

Hereditary antithrombin deficiency — treatment and prevention of thromboembolism; prevention of peri-operative and peri-partum thromboembolism

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Frequently Asked Questions

Is there an available Thrombate Iii billing and coding guide?
We have not yet identified a manufacturer source of Thrombate Iii billing and coding information.
Are there any available Thrombate Iii patient assistance programs?
Our team did not identify a source for Thrombate Iii patient assistance information. Please reach out to our team if you feel that this is a mistake.
Where can I find Thrombate Iii prescribing information?
THROMBATE III prescribing information can be found at the link below: Visit Here →
Where can I find Thrombate Iii side effect information?
Our team has not yet identified a source of side effects information for THROMBATE III. Please check back in a few weeks.
Does billing THROMBATE III require JZ/JW wastage modifiers?
CMS has identified THROMBATE III(J7197) 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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