J1554 HCPCS code: Injection, immune globulin (asceniv), 500 mg
J1554 is the HCPCS Level II code for injection, immune globulin (asceniv), 500 mg. In 2024 Medicare paid an average of $384.46 per service for J1554 across 94,549 services. Its Medicare coverage code is C (Carrier judgment): Coverage is decided by the Medicare contractor (MAC) case by case. The NCCI unit limit is 240 per day on DME suppliers. Medicare volume rose 567% from 2022 to 2024 (14,180 to 94,549 services). In 2024, 46 suppliers billed Medicare for J1554 (purchases), serving 131 beneficiaries; Florida, Texas, Georgia accounted for 32% of services.
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 | 2021-04-01 |
| Last action effective | 2021-04-01 |
Who bills J1554 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 46 |
| Referring clinicians | 115 |
| Medicare beneficiaries | 131 |
| States with claims | 23 |
| Share of services in top 3 states (Florida, Texas, Georgia) | 32% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 16 | 32 |
| 2023 | 28 | 89 |
| 2024 | 46 | 131 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1554, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 14,180 | 25 | $473.43 | $377.72 |
| 2023 | 38,964 | 75 | $480.80 | $383.06 |
| 2024 | 94,549 | 126 | $482.58 | $384.46 |
States with the most J1554 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Texas | 25,800 | $385.21 |
| Ohio | 19,534 | $385.23 |
| Missouri | 11,890 | $385.14 |
| Florida | 11,000 | $385.24 |
| Kansas | 7,375 | $380.74 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 240 | Prescribing Information |
| outpatient hospital claims | 240 | Prescribing Information |
| practitioner claims | 240 | Prescribing Information |
Medicare policy articles for this code
- A56718: Billing and Coding: Intravenous Immunoglobulin (IVIG) (Palmetto GBA (MAC - Part A, MAC - Part B))
- 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))
- A57554: Billing and Coding: Immune Globulins (WPS Insurance Corporation (MAC - Part A, MAC - Part B))
- A57778: Billing and Coding: Immune Globulin (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))
- A59105: Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG) (Wellpoint Federal (MAC - Part A, MAC - Part B))
Covered diagnoses (1,441 ICD-10-CM codes)
The diagnoses most often listed as covered in the policy articles above:
| ICD-10-CM | Diagnosis | Articles listing it |
|---|---|---|
| C90.00 | Multiple myeloma not having achieved remission | 6 |
| C90.02 | Multiple myeloma in relapse | 6 |
| C91.10 | Chronic lymphocytic leukemia of B-cell type not having achieved remission | 6 |
| C91.12 | Chronic lymphocytic leukemia of B-cell type in relapse | 6 |
| D59.0 | Drug-induced autoimmune hemolytic anemia | 6 |
| D59.11 | Warm autoimmune hemolytic anemia | 6 |
| D59.12 | Cold autoimmune hemolytic anemia | 6 |
| D59.13 | Mixed type autoimmune hemolytic anemia | 6 |
| D69.3 | Immune thrombocytopenic purpura | 6 |
| D80.0 | Hereditary hypogammaglobulinemia | 6 |
Showing 10 of 1,441. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1554
- 2021-04-01: J1554 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 J1554?
J1554 is the HCPCS Level II code for injection, immune globulin (asceniv), 500 mg. Short descriptor: "Inj. asceniv".
How much does Medicare pay for J1554?
In 2024, the average Medicare payment was $384.46 per service (average allowed $482.58).
Does Medicare cover J1554?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J1554?
Medicare policy articles that cite J1554 list 1,441 covered ICD-10-CM diagnosis codes across 6 articles. The most cited include C90.00 (Multiple myeloma not having achieved remission), C90.02 (Multiple myeloma in relapse), C91.10 (Chronic lymphocytic leukemia of B-cell type not having achieved remission). A listed diagnosis is necessary but not sufficient; the policy's other criteria still apply.
How many units of J1554 can be billed per day?
240 on DME suppliers; 240 on outpatient hospital claims; 240 on practitioner claims (NCCI medically unlikely edits).
Related J15 codes
- J1551 — Injection, immune globulin (cutaquig), 100 mg
- J1552 — Injection, immune globulin (alyglo), 500 mg
- J1553 — Injection, immune globulin (yimmugo), 100 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
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Next steps
- Run a reimbursement report for a device billed under J1554
- Watch J1554 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1554
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.