HCPCS J1569

Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg (CMS descriptor)

Drugs Drug code Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

389
78th percentile among 6,326 codes billed · 2022
$73M
97th percentile among 6,326 codes billed · 2022
2.0M
97th percentile among 6,326 codes billed · 2022
3,680
98th percentile among 6,326 codes billed · 2022
14,524
98th percentile among 6,326 codes billed · 2022
+5.9%
Medicare payment on the code vs 2021; billers +17.2% · 2022

Trend

Medicare payment on the code

$0$50M$100M2020: $65M paid20202021: $69M paid20212022: $73M paid20222023: $98M paid20232024: $101M paid2024$101M$0$50M$100M2020: $65M paid20202021: $69M paid20212022: $73M paid20222023: $98M paid20232024: $101M paid2024$101M$0$50M$100M2020: $65M paid20202021: $69M paid20212022: $73M paid20222023: $98M paid20232024: $101M paid2024$101M$0$50M$100M2020: $65M paid20202021: $69M paid20212022: $73M paid20222023: $98M paid20232024: $101M paid2024$101M

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

02505002020: 350 providers20202021: 332 providers20212022: 389 providers20222023: 542 providers20232024: 593 providers202459302505002020: 350 providers20202021: 332 providers20212022: 389 providers20222023: 542 providers20232024: 593 providers202459302505002020: 350 providers20202021: 332 providers20212022: 389 providers20222023: 542 providers20232024: 593 providers202459302505002020: 350 providers20202021: 332 providers20212022: 389 providers20222023: 542 providers20232024: 593 providers2024593

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
2024593$101,026,285+3%2,848,1013,24511,4110.00
2023542$98,127,656+35%2,757,6873,52412,0910.00
2022389$72,656,233+6%2,045,6933,68014,5240.00
2021332$68,609,792+6%1,908,6464,26615,4740.00
2020350$64,929,749first year in data2,022,9034,28915,0760.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
Florida121$23,101,842642,6104,83511,370
Texas21$5,764,608165,1193,68015,900
California15$5,364,547149,8002,65041,183
Illinois33$4,606,773130,3962,8238,913
Ohio18$4,140,484119,3173,36018,174
Arizona34$3,940,149110,5801,05515,020
Virginia21$2,216,24262,5422,1907,994
Arkansas12$1,746,65949,0543,1058,957
North Carolina12$1,294,76136,3572,8334,839

Not listed: 23 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2022.

Top metro areas

observed calculated calculated calculated calculated
North Port-Bradenton-Sarasota, FL19$4,360,072121,2726,650
Los Angeles-Long Beach-Anaheim, CA12$4,000,454111,6302,415
Phoenix-Mesa-Chandler, AZ33$3,913,519109,8291,120
Chicago-Naperville-Elgin, IL-IN27$3,775,383107,1462,823
Tampa-St. Petersburg-Clearwater, FL12$2,412,21267,2306,071
Cape Coral-Fort Myers, FL13$2,367,50765,4123,778
Kansas City, MO-KS11$1,934,88354,6724,120
Richmond, VA15$1,365,43338,6202,340
Jacksonville, FL21$1,092,73330,6001,550

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 9 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2022.

Specialties billing J1569 nationally

Hematology-Oncology accounts for 43% of payment for J1569 nationally in 2022, across 7 specialties on claims.

observed calculated calculated calculated calculated calculated
Hematology-Oncology21455%$30,908,74443%867,5294,054
Medical Oncology4311%$7,952,82311%222,5945,177
Nurse Practitioner379.5%$7,276,29410%207,3215,603
Allergy/ Immunology184.6%$5,321,3607.3%149,5608,309
Internal Medicine143.6%$2,875,3344.0%80,7655,769
Rheumatology153.9%$2,684,1293.7%76,1985,080
Infectious Disease133.3%$2,341,4563.2%65,7085,054

Not listed: 9 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2022.

Top billers of J1569 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations