J1570 HCPCS code: Injection, ganciclovir sodium, 500 mg
J1570 is the HCPCS Level II code for injection, ganciclovir sodium, 500 mg. In 2024 Medicare paid an average of $21.29 per service for J1570 across 147 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 18 per day on DME suppliers. Medicare volume fell 12% from 2022 to 2024 (167 to 147 services). In 2024, 66 suppliers billed Medicare for J1570 (purchases), serving 158 beneficiaries; Texas, Pennsylvania, Virginia accounted for 37% of services.
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 | 1994-01-01 |
| Last action effective | 1997-01-01 |
Who bills J1570 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 66 |
| Referring clinicians | 176 |
| Medicare beneficiaries | 158 |
| States with claims | 20 |
| Share of services in top 3 states (Texas, Pennsylvania, Virginia) | 37% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 92 | 229 |
| 2023 | 80 | 216 |
| 2024 | 66 | 158 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1570, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 167 | 38 | $44.09 | $34.97 |
| 2023 | 317 | 36 | $38.35 | $30.56 |
| 2024 | 147 | 28 | $27.03 | $21.29 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 18 | Clinical: Data |
| outpatient hospital claims | 4 | Prescribing Information |
| practitioner claims | 4 | Prescribing Information |
What changed for J1570
- 1994-01-01: J1570 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 J1570?
J1570 is the HCPCS Level II code for injection, ganciclovir sodium, 500 mg. Short descriptor: "Ganciclovir sodium injection".
How much does Medicare pay for J1570?
In 2024, the average Medicare payment was $21.29 per service (average allowed $27.03).
Does Medicare cover J1570?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1570 can be billed per day?
18 on DME suppliers; 4 on outpatient hospital claims; 4 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
- 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
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 J1570
- Watch J1570 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1570
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.