J1572 — Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg
J1572 is a HCPCS Level II code for injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg. It belongs to the Drugs Administered Other Than Oral Method section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Special coverage instructions apply
There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusE
Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of J1572 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 180 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- outpatient
- 180 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
- DME supplier
- 180 units MAI 3 — Date of Service Edit: Clinical · Prescribing Information
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for J1572
- Long descriptor
- Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg
- Short descriptor
- Flebogamma injection
- Added
- January 1, 2008
- BETOS
- O1E
- Pricing indicator
- 51 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Drugs.
Codes adjacent to J1572
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If J1572 is not quite right, the correct code is very often within a few positions of it.
- J1560Injection, gamma globulin, intramuscular, over 10 cc
- J1561Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg
- J1562Injection, immune globulin (vivaglobin), 100 mgterminated
- J1566Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg
- J1568Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg
- J1569Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg
- J1570Injection, ganciclovir sodium, 500 mg
- J1571Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml
- J1573Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml
- J1574Injection, ganciclovir sodium (exela), not therapeutically equivalent to j1570, 500 mg
- J1575Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin
- J1576Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg
- J1577Injection, immune globulin (qivigy), 100 mg
- J1580Injection, garamycin, gentamicin, up to 80 mg
- J1590Injection, gatifloxacin, 10 mgterminated
- J1595Injection, glatiramer acetate, 20 mg
Questions about J1572
What is HCPCS code J1572?
J1572 is a HCPCS Level II code for injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg. It sits in the Drugs Administered Other Than Oral Method section.
Does Medicare cover J1572?
The CMS HCPCS file marks J1572 as "Special coverage instructions apply". There are published conditions attached to this code. Check the applicable coverage policy before billing it: the code being valid is not the same as the service being covered.
How is J1572 paid under the physician fee schedule?
J1572 carries PFS status code E. Excluded from the physician fee schedule by regulation. Payment, where it exists, comes from another fee schedule (drugs via ASP, supplies via DMEPOS, and so on).