J1553 HCPCS code: Injection, immune globulin (yimmugo), 100 mg
J1553 is the HCPCS Level II code for injection, immune globulin (yimmugo), 100 mg. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case.
Code details
| Field | Value |
|---|---|
| Section | J codes — Drugs administered other than oral method |
| Coverage code | C — Carrier judgment |
| Pricing indicator | 51 — Drug or biological (priced per ASP/average sales price rules) |
| BETOS category | O1E — Other drugs |
| Added | 2026-04-01 |
| Last action effective | 2026-04-01 |
Medicare policy articles for this code
- A52509: Intravenous Immune Globulin - Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC)) — mentions this code in its coding guidance
- A56786: Billing and Coding: Immune Globulin (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B))
- A57187: Billing and Coding: Immune Globulin Intravenous (IVIg) (Noridian Healthcare Solutions, LLC (MAC - Part A, MAC - Part B))
- A57778: Billing and Coding: Immune Globulin (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))
Covered diagnoses (149 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| D80.0 | Hereditary hypogammaglobulinemia | 4 |
| D80.2 | Selective deficiency of immunoglobulin A [IgA] | 4 |
| D80.3 | Selective deficiency of immunoglobulin G [IgG] subclasses | 4 |
| D80.4 | Selective deficiency of immunoglobulin M [IgM] | 4 |
| D80.5 | Immunodeficiency with increased immunoglobulin M [IgM] | 4 |
| D80.6 | Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia | 4 |
| D80.7 | Transient hypogammaglobulinemia of infancy | 4 |
| D81.0 | Severe combined immunodeficiency [SCID] with reticular dysgenesis | 4 |
| D81.1 | Severe combined immunodeficiency [SCID] with low T- and B-cell numbers | 4 |
| D81.2 | Severe combined immunodeficiency [SCID] with low or normal B-cell numbers | 4 |
Showing 10 of 149. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1553
- April 2026: Code appears in this HCPCS release
- 2026-04-01: J1553 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 J1553?
J1553 is the HCPCS Level II code for injection, immune globulin (yimmugo), 100 mg. Short descriptor: "Inj yimmugo 100 mg".
Does Medicare cover J1553?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J1553?
Medicare policy articles that cite J1553 list 149 covered ICD-10-CM diagnosis codes across 4 articles. The most cited include D80.0 (Hereditary hypogammaglobulinemia), D80.2 (Selective deficiency of immunoglobulin A [IgA]), D80.3 (Selective deficiency of immunoglobulin G [IgG] subclasses). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
Related J15 codes
- J1551 — Injection, immune globulin (cutaquig), 100 mg
- J1552 — Injection, immune globulin (alyglo), 500 mg
- J1554 — Injection, immune globulin (asceniv), 500 mg
- J1555 — Injection, immune globulin (cuvitru), 100 mg
- J1556 — Injection, immune globulin (bivigam), 500 mg
- J1557 — Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg
- J1558 — Injection, immune globulin (xembify), 100 mg
- J1559 — Injection, immune globulin (hizentra), 100 mg
- J1560 — Injection, gamma globulin, intramuscular, over 10 cc
- J1561 — Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg
- J1562 — Injection, immune globulin (vivaglobin), 100 mg
- J1566 — Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 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 J1553
- Watch J1553 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1553
Sources: CMS HCPCS Level II release October 2026; 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.