THROMBATE III J Code: J7197
Antithrombin iii (human), per i.u.
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.
Drug & Product Overview
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 |
THROMBATE III Pricing & Reimbursement
National median reimbursement across major commercial payers.
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Login to use the calculator →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) |
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.
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 →
THROMBATE III Clinical Information
Indications and drug classification.
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.
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Frequently Asked Questions
Is there an available Thrombate Iii billing and coding guide?
Are there any available Thrombate Iii patient assistance programs?
Where can I find Thrombate Iii prescribing information?
Where can I find Thrombate Iii side effect information?
Does billing THROMBATE III require JZ/JW wastage modifiers?
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