J1460 HCPCS code: Injection, gamma globulin, intramuscular, 1 cc
J1460 is the HCPCS Level II code for injection, gamma globulin, intramuscular, 1 cc. In 2024 Medicare paid an average of $36.20 per service for J1460 across 940 services. Its Medicare coverage code is D (Special coverage instructions apply): Medicare covers it when its national or local coverage criteria are met. The NCCI unit limit is 10 per day on outpatient hospital claims. Medicare volume fell 44% from 2022 to 2024 (1,671 to 940 services). In 2024, about 36 clinicians billed Medicare for J1460 for 62 beneficiaries.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | D — Special coverage instructions apply |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 1984-01-01 |
| Last action effective | 2017-01-01 |
Who bills J1460 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 36 |
| Medicare beneficiaries | 62 |
| States with claims | 1 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1460, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 1,671 | 78 | $43.21 | $33.16 |
| 2023 | 1,655 | 101 | $43.81 | $34.04 |
| 2024 | 940 | 62 | $48.08 | $36.20 |
States with the most J1460 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| California | 585 | $36.37 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 10 | Code Descriptor / CPT Instruction |
| practitioner claims | 10 | Code Descriptor / CPT Instruction |
Medicare policy articles for this code
- A57160: Billing and Coding: Immune Thrombocytopenia (ITP) Therapy (CGS Administrators, LLC (MAC - Part A, MAC - Part B))
- A57554: Billing and Coding: Immune Globulins (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
Covered diagnoses (1,176 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| D69.3 | Immune thrombocytopenic purpura | 2 |
| B16.1 | Acute hepatitis B with delta-agent without hepatic coma | 1 |
| B16.2 | Acute hepatitis B without delta-agent with hepatic coma | 1 |
| B16.9 | Acute hepatitis B without delta-agent and without hepatic coma | 1 |
| B17.0 | Acute delta-(super) infection of hepatitis B carrier | 1 |
| B18.0 | Chronic viral hepatitis B with delta-agent | 1 |
| B18.1 | Chronic viral hepatitis B without delta-agent | 1 |
| B19.10 | Unspecified viral hepatitis B without hepatic coma | 1 |
| B19.11 | Unspecified viral hepatitis B with hepatic coma | 1 |
| B20 | Human immunodeficiency virus [HIV] disease | 1 |
Showing 10 of 1,176. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1460
- 1984-01-01: J1460 added to HCPCS Level II
- Next scheduled CMS quarterly update (HCPCS and DMEPOS fee schedule): 2027-01-01
Frequently asked questions
What is HCPCS code J1460?
J1460 is the HCPCS Level II code for injection, gamma globulin, intramuscular, 1 cc. Short descriptor: "Gamma globulin 1 cc inj".
How much does Medicare pay for J1460?
In 2024, the average Medicare payment was $36.20 per service (average allowed $48.08).
Does Medicare cover J1460?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J1460?
Medicare policy articles that cite J1460 list 1,176 covered ICD-10-CM diagnosis codes across 2 articles. The most cited include D69.3 (Immune thrombocytopenic purpura), B16.1 (Acute hepatitis B with delta-agent without hepatic coma), B16.2 (Acute hepatitis B without delta-agent with hepatic coma). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J1460 can be billed per day?
10 on outpatient hospital claims; 10 on practitioner claims (NCCI medically unlikely edits).
Related J14 codes
- J1410 — Injection, estrogen conjugated, per 25 mg
- J1411 — Injection, etranacogene dezaparvovec-drlb, per therapeutic dose
- J1412 — Injection, valoctocogene roxaparvovec-rvox, per ml, containing nominal 2 x 10^13 vector genomes
- J1413 — Injection, delandistrogene moxeparvovec-rokl, per therapeutic dose
- J1414 — Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose
- J1426 — Injection, casimersen, 10 mg
- J1427 — Injection, viltolarsen, 10 mg
- J1428 — Injection, eteplirsen, 10 mg
- J1429 — Injection, golodirsen, 10 mg
- J1430 — Injection, ethanolamine oleate, 100 mg
- J1434 — Injection, fosaprepitant (focinvez), 1 mg
- J1435 — Injection, estrone, per 1 mg
Building a device that would bill under a code like this? Caduvo matches a device description to HCPCS/CPT codes, Medicare coverage and payment, and the FDA pathway in one report.
Next steps
- Run a reimbursement report for a device billed under J1460
- Watch J1460 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1460
Sources: CMS HCPCS Level II release October 2025; CMS DMEPOS fee schedule; CMS NCCI MUE tables; CMS Medicare utilization (physician and DME supplier files); CMS Medicare Coverage Database articles. Fees are Medicare allowables, not commercial rates. Not billing or legal advice.