J1555 HCPCS code: Injection, immune globulin (cuvitru), 100 mg
J1555 is the HCPCS Level II code for injection, immune globulin (cuvitru), 100 mg. In 2024 Medicare paid an average of $12.44 per service for J1555 across 81,529 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 1500 per day on DME suppliers. Medicare volume rose 184% from 2022 to 2024 (28,662 to 81,529 services). In 2024, 218 suppliers billed Medicare for J1555 (purchases), serving 1,840 beneficiaries; Florida, California, Texas accounted for 36% 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 | D1G — Drugs administered through DME |
| Added | 2018-01-01 |
| Last action effective | 2018-01-01 |
Who bills J1555 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 218 |
| Referring clinicians | 974 |
| Medicare beneficiaries | 1,840 |
| States with claims | 47 |
| Share of services in top 3 states (Florida, California, Texas) | 36% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 189 | 1,477 |
| 2023 | 201 | 1,636 |
| 2024 | 218 | 1,840 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1555, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 28,662 | 18 | $12.72 | $10.16 |
| 2023 | 49,418 | 29 | $13.06 | $10.39 |
| 2024 | 81,529 | 34 | $15.63 | $12.44 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 1500 | Clinical: CMS Workgroup |
| outpatient hospital claims | 480 | Prescribing Information |
| practitioner claims | 480 | Prescribing Information |
Medicare policy articles for this code
- A52507: External Infusion Pumps - 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))
- A57778: Billing and Coding: Immune Globulin (First Coast Service Options, Inc. (MAC - Part A, MAC - Part B))
Covered diagnoses (542 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 | 3 |
| D80.2 | Selective deficiency of immunoglobulin A [IgA] | 3 |
| D80.3 | Selective deficiency of immunoglobulin G [IgG] subclasses | 3 |
| D80.4 | Selective deficiency of immunoglobulin M [IgM] | 3 |
| D80.5 | Immunodeficiency with increased immunoglobulin M [IgM] | 3 |
| D80.6 | Antibody deficiency with near-normal immunoglobulins or with hyperimmunoglobulinemia | 3 |
| D80.7 | Transient hypogammaglobulinemia of infancy | 3 |
| D81.0 | Severe combined immunodeficiency [SCID] with reticular dysgenesis | 3 |
| D81.1 | Severe combined immunodeficiency [SCID] with low T- and B-cell numbers | 3 |
| D81.2 | Severe combined immunodeficiency [SCID] with low or normal B-cell numbers | 3 |
Showing 10 of 542. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1555
- 2018-01-01: J1555 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 J1555?
J1555 is the HCPCS Level II code for injection, immune globulin (cuvitru), 100 mg. Short descriptor: "Inj cuvitru, 100 mg".
How much does Medicare pay for J1555?
In 2024, the average Medicare payment was $12.44 per service (average allowed $15.63).
Does Medicare cover J1555?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J1555?
Medicare policy articles that cite J1555 list 542 covered ICD-10-CM diagnosis codes across 3 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.
How many units of J1555 can be billed per day?
1500 on DME suppliers; 480 on outpatient hospital claims; 480 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
- J1554 — Injection, immune globulin (asceniv), 500 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 J1555
- Watch J1555 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1555
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.