Injectafer (J1439) cost and reimbursement per dose

$1.132 per mg is Part B's ASP+6% rate for Q3 2026. Medicare pays J1439 per 1 mg billing unit — a 750 mg dose is 750 units, and units equal the ordered mg directly, no conversion step. On the default 750 mg dose that is $849.00 for the drug, and the administration line (96374, $37.74) is only 4.3% of the $886.74 allowed amount — nowhere near the near-even split on a cheaper iron. The push (96374–96376) and infusion (96365–96366) code pages carry the full definitions; for Injectafer the only question that matters is whether the documented time crosses 15 minutes, since a 750 mg push at about 100 mg/min runs roughly half that. Full explanation: How Medicare Part B drug cost sharing works →

What a full two-dose course costs

The labeled iron-deficiency-anemia course for a patient 50 kg and over is two 750 mg doses at least 7 days apart — 1,500 mg per course, not an open-ended schedule. Each dose is its own claim, each with its own 96374 administration line:

Administration is only about 4% of the course total here, unlike a cheaper iron where it runs closer to half the bill. A denied or downcoded 96374 line on either visit still costs the practice $37.74 — real money, but small next to an $849.00 drug line, which is where a pricing error on this drug actually hurts.

Iron-deficiency anemia and the non-dialysis CKD indication both dose the same way — 750 mg twice, at least 7 days apart, for a patient 50 kg and over — so the estimator's 750 mg default prices either diagnosis without a separate setting. The label also allows a single 15 mg/kg dose up to 1,000 mg for a patient who cannot return for a second visit, and a weight-based 15 mg/kg-per-dose rule from age 1 year for anyone under 50 kg. Those are the three regimens above.

The heart-failure indication is different in kind, not degree: the label sets the dose from a table of weight (under 70 kg or 70 kg and over) crossed with hemoglobin (under 10, 10 to 14, or over 14 to under 15 g/dL), with a 1,000 mg or 500 mg Day 1 dose, a Week 6 dose or none, and 500 mg maintenance doses at weeks 12, 24 and 36 if ferritin or transferrin saturation still qualify. No single number describes it, so it is not one of the estimator's choices — it is priced by looking up the row that matches the patient, not by picking a setting:

Maintenance doses of 500 mg at weeks 12, 24 and 36 are added if ferritin is under 100 ng/mL, or 100 to 300 ng/mL with transferrin saturation under 20%. A 1,000 mg Day 1 dose allows $1,132.00 for the drug plus $37.74 for 96374, the same $1,169.74 as the single-dose IDA visit above; a 500 mg dose allows $566.00 plus $37.74. There is no cumulative price for this regimen on this page — it depends on how many maintenance doses a given patient's labs call for, up to 36 weeks.

For a 750 mg dose with the 96374 IV push administration code, Medicare allows $886.74, and the Part B coinsurance on that is $177.35. Plans A, B, C, D, F, G, M and N cover that coinsurance in full, so those patients owe nothing per dose once the $283 deductible is met; Plan K leaves $88.67 and Plan L $44.34. The single 1,000 mg dose has its own, larger coinsurance: it allows $1,169.74, so 20% of it is $233.95 — more than the $177.35 owed on a 750 mg visit, the same one-bigger-bill-instead-of-two trade as the course total below.

Unlike a drug whose whole claim is smaller than the deductible, a single Injectafer visit ($886.74) is more than three times the $283 Part B deductible, so the deductible is a one-time partial hit rather than a recurring one. Whichever visit in the course happens to land before the deductible is met absorbs the full $283 plus 20% of the remaining $603.74 ($120.75), for $403.75 on that visit; every other visit in the year is a plain $177.35 coinsurance. Across the two-visit course, a patient who has not yet met the deductible pays $403.75 on the first visit and $177.35 on the second, for $581.10 total — against $354.70 if the deductible was already met before the course started.

That is why the month a course starts still matters here, even though the claim itself is large enough that Medigap coverage, not the deductible, decides most of what full-coverage-plan patients owe. See what each Medigap plan (A–N) owes on this claim →

Only the letters that leave this patient a balance are listed. The full A–N grid, the high-deductible variants, Plan N’s office-visit carve-out and the MACRA restriction on Plans C and F are at Medigap Plans A–N.

Commercial payers negotiate their own rate for J1439, not ASP+6% — Aetna's median published rate across the corpus is about $1.13 per mg, close to Medicare's $1.132, putting a 750 mg dose at about $847.50 before benefits. Full explanation: How commercial drug reimbursement works →

Priced per 1,000 mg of elemental iron at Q3 2026 ASP+6%, Injectafer runs about 5x Venofer's price for the same job — the question worth asking is what that difference buys back in visits:

A 12x spread separates the cheapest and most expensive products in this class for the same 1,000 mg of iron, and Injectafer sits near the top of it: about 5x Venofer's price for the same iron. What Venofer does not buy back is visits — its labeled course for that same 1,000 mg is five separate 200 mg doses, each with its own 96374 line, for a total of $415.70 allowed. Matched to that same 1,000 mg, Injectafer's single-dose alternative allows $1,169.74 in one visit — 2.8x the money, but four fewer visits.

Injectafer's labeled two-dose course prices a different, larger quantity: 1,500 mg across two visits for $1,773.48 allowed, not a like-for-like match to Venofer's 1,000 mg course. The visit count, not the drug, is what a cheaper iron actually saves a payer.

11 of the 16 payers in this corpus make a patient fail another IV iron before they pay for Injectafer; UHC and Independence require failure on two. See how each payer writes that rule → This table compares Medicare allowed amounts only; it is not a clinical recommendation, and no product here is more or less clinically appropriate than another based on price alone.

American Regent runs the Injectafer Savings Program for commercially insured patients: $50 per dose, with the program paying up to $500 per dose toward the drug, capped at $2,000 and four doses per calendar year. It covers the drug only — the $37.74 96374 charge is billed and owed separately, so a commercial patient using the card still sees an administration line the card does not touch. Medicare, Medicaid, TRICARE and federal-plan patients are excluded from the card; DS Access Central offers free drug to uninsured patients or those in a coverage gap. Full assistance program details →

D50.9 (iron deficiency anemia, unspecified) is the reference code on this page; the same iron-deficiency-anemia indication also bills D50.0 or D50.8 when the chart documents which one. D63.1 (anemia in chronic kidney disease) is the primary code for the non-dialysis CKD indication, paired with a CKD stage or dialysis-status code from N18.30 through N18.5. The heart-failure indication's primary code is E61.1 (iron deficiency), paired with a billable I50 heart- failure child code such as I50.22 or I50.32.

A three-character heart-failure category code by itself is not billable, and neither is the three-character iron-deficiency-anemia category on its own — both need the added digit(s) that make them a specific, billable code.