J1576 HCPCS code: Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg
J1576 is the HCPCS Level II code for injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg. In 2024 Medicare paid an average of $51.78 per service for J1576 across 651,759 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 600 per day on outpatient hospital claims. Medicare volume rose 129% from 2023 to 2024 (285,062 to 651,759 services). In 2024, about 385 clinicians billed Medicare for J1576 for 668 beneficiaries; Tennessee, Texas, Arizona accounted for 55% 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 | 2023-07-01 |
| Last action effective | 2023-07-01 |
Who bills J1576 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 385 |
| Medicare beneficiaries | 668 |
| States with claims | 13 |
| Share of services in top 3 states (Tennessee, Texas, Arizona) | 55% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1576, 2023–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2023 | 285,062 | 468 | $64.20 | $51.15 |
| 2024 | 651,759 | 668 | $65.03 | $51.78 |
States with the most J1576 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Tennessee | 137,375 | $52.95 |
| Texas | 111,970 | $51.37 |
| Arizona | 62,900 | $50.15 |
| Maryland | 58,580 | $52.48 |
| Florida | 39,373 | $51.01 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 600 | Prescribing Information |
| practitioner claims | 600 | 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))
- 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) (National Government Services, Inc. (MAC - Part A, MAC - Part B))
Covered diagnoses (412 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 | 5 |
| C90.02 | Multiple myeloma in relapse | 5 |
| C91.10 | Chronic lymphocytic leukemia of B-cell type not having achieved remission | 5 |
| C91.12 | Chronic lymphocytic leukemia of B-cell type in relapse | 5 |
| D59.0 | Drug-induced autoimmune hemolytic anemia | 5 |
| D59.11 | Warm autoimmune hemolytic anemia | 5 |
| D59.12 | Cold autoimmune hemolytic anemia | 5 |
| D59.13 | Mixed type autoimmune hemolytic anemia | 5 |
| D69.3 | Immune thrombocytopenic purpura | 5 |
| D80.0 | Hereditary hypogammaglobulinemia | 5 |
Showing 10 of 412. The full list, non-covered diagnoses and CSV export are in Caduvo.
What changed for J1576
- 2023-07-01: J1576 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 J1576?
J1576 is the HCPCS Level II code for injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg. Short descriptor: "Inj, panzyga, 500 mg".
How much does Medicare pay for J1576?
In 2024, the average Medicare payment was $51.78 per service (average allowed $65.03).
Does Medicare cover J1576?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
Which diagnoses support coverage for J1576?
Medicare policy articles that cite J1576 list 412 covered ICD-10-CM diagnosis codes across 5 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 J1576 can be billed per day?
600 on outpatient hospital claims; 600 on practitioner claims (NCCI medically unlikely edits).
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
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Next steps
- Run a reimbursement report for a device billed under J1576
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Sources: CMS HCPCS Level II release October 2025; 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.