J1575 HCPCS code: Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin
J1575 is the HCPCS Level II code for injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin. In 2024 Medicare paid an average of $13.39 per service for J1575 across 831,182 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 3000 per day on DME suppliers. Medicare volume rose 7% from 2022 to 2024 (775,301 to 831,182 services). In 2024, 181 suppliers billed Medicare for J1575 (purchases), serving 872 beneficiaries; Florida, Texas, New York accounted for 33% 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 | 2016-01-01 |
| Last action effective | 2016-01-01 |
Who bills J1575 (2024)
| Measure | Value |
|---|---|
| Suppliers billing rentals | — |
| Suppliers billing purchases | 181 |
| Referring clinicians | 652 |
| Medicare beneficiaries | 872 |
| States with claims | 46 |
| Share of services in top 3 states (Florida, Texas, New York) | 33% |
| Year | Suppliers | Beneficiaries |
|---|---|---|
| 2022 | 179 | 822 |
| 2023 | 176 | 826 |
| 2024 | 181 | 872 |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1575, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 775,301 | 247 | $15.37 | $12.27 |
| 2023 | 799,520 | 260 | $16.07 | $12.79 |
| 2024 | 831,182 | 270 | $16.82 | $13.39 |
States with the most J1575 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Tennessee | 172,925 | $13.45 |
| Texas | 156,900 | $13.46 |
| New York | 82,017 | $13.41 |
| New Jersey | 71,601 | $13.48 |
| Florida | 67,350 | $13.46 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| DME suppliers | 3000 | Prescribing Information |
| outpatient hospital claims | 3000 | Prescribing Information |
| practitioner claims | 3000 | 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))
- 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))
Covered diagnoses (1,631 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 1,631. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1575
- 2016-01-01: J1575 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 J1575?
J1575 is the HCPCS Level II code for injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin. Short descriptor: "Hyqvia 100mg immuneglobulin".
How much does Medicare pay for J1575?
In 2024, the average Medicare payment was $13.39 per service (average allowed $16.82).
Does Medicare cover J1575?
Coverage code C — Carrier judgment. Coverage is decided by the Medicare contractor (MAC) case by case.
Which diagnoses support coverage for J1575?
Medicare policy articles that cite J1575 list 1,631 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.
How many units of J1575 can be billed per day?
3000 on DME suppliers; 3000 on outpatient hospital claims; 3000 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 J1575
- Watch J1575 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1575
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.