J1580 HCPCS code: Injection, garamycin, gentamicin, up to 80 mg
J1580 is the HCPCS Level II code for injection, garamycin, gentamicin, up to 80 mg. In 2024 Medicare paid an average of $1.91 per service for J1580 across 82,864 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 9 per day on outpatient hospital claims. Medicare volume fell 2% from 2022 to 2024 (84,466 to 82,864 services). In 2024, about 5,053 clinicians billed Medicare for J1580 for 38,005 beneficiaries; Florida, California, Texas accounted for 34% 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 | 1984-01-01 |
| Last action effective | 1997-01-01 |
Who bills J1580 (2024)
| Measure | Value |
|---|---|
| Clinicians billing (by place of service) | 5,053 |
| Medicare beneficiaries | 38,005 |
| States with claims | 51 |
| Share of services in top 3 states (Florida, California, Texas) | 34% |
Counts only. Supplier and clinician names, contact lists and state-by-state detail are in Caduvo.
Medicare utilization for J1580, 2022–2024
| Year | Services | Beneficiaries | Avg. allowed | Avg. paid |
|---|---|---|---|---|
| 2022 | 84,466 | 40,125 | $1.89 | $1.46 |
| 2023 | 82,940 | 38,458 | $2.71 | $2.10 |
| 2024 | 82,864 | 38,005 | $2.48 | $1.91 |
States with the most J1580 services (2024)
| State | Services | Avg. paid |
|---|---|---|
| Florida | 11,442 | $1.95 |
| California | 10,009 | $1.95 |
| Texas | 6,994 | $1.90 |
| New Jersey | 4,475 | $1.95 |
| Tennessee | 4,353 | $1.83 |
NCCI unit limits (MUE)
| Claim type | Max units per day | Rationale |
|---|---|---|
| outpatient hospital claims | 9 | Prescribing Information |
| practitioner claims | 9 | Prescribing Information |
What changed for J1580
- 1984-01-01: J1580 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 J1580?
J1580 is the HCPCS Level II code for injection, garamycin, gentamicin, up to 80 mg. Short descriptor: "Garamycin gentamicin inj".
How much does Medicare pay for J1580?
In 2024, the average Medicare payment was $1.91 per service (average allowed $2.48).
Does Medicare cover J1580?
Coverage code D — Special coverage instructions apply. Medicare covers it when its national or local coverage criteria are met.
How many units of J1580 can be billed per day?
9 on outpatient hospital claims; 9 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 J1580
- Watch J1580 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for J1580
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.