ASP Drug Pricing - (1st Quarter)
January 2026
Payment Allowance Limits for Medicare Part B Drugs

  • Note 1: Payment allowance limits subject to the ASP methodology are based on Jul 2025 (3nd Quarter) ASP data.
  • Note 2: The absence or presence of a HCPCS code and the payment allowance limits in this table does not indicate whether Medicare covers a drug. These determinations shall be made by the local Medicare contractor processing the claim.
 
Page 12 * Effective January 1, 2026 through March 31, 2026
HCPCS Code Code Dosage Payment
Limit		 Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
J1556 - Injection, immune globulin (bivigam), 500 mg 500 MG 79.645 - - - - - -
J1557 - Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg 500 MG 63.931 - - - - - -
J1558 - Injection, immune globulin (xembify), 100 mg 100 MG 15.056 - - - - - -
J1559 - Injection, immune globulin (hizentra), 100 mg 100 MG 14.543 - - - - - -
J1560 - Injection, gamma globulin, intramuscular, over 10 cc 10 CC 104.520 - - - - - -
J1561 - Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg 500 MG 49.076 - - - - - -
J1566 - Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg 500 MG 78.892 - - - - - -
J1568 - Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg 500 MG 47.385 - - - - - -
J1569 - Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg 500 MG 47.288 - - - - - -
J1570 - Injection, ganciclovir sodium, 500 mg 500 MG 33.522 - - - - - -
J1571 - Injection, hepatitis b immune globulin (hepagam b), intramuscular, 0.5 ml 0.5 ML 69.585 - - - - - -
J1573 - Injection, hepatitis b immune globulin (hepagam b), intravenous, 0.5 ml 0.5 ML 69.585 - - - - - -
J1575 - Injection, immune globulin/hyaluronidase, (hyqvia), 100 mg immuneglobulin 100 MG 18.325 - - - - - -
J1576 - Injection, immune globulin (panzyga), intravenous, non-lyophilized (e.g., liquid), 500 mg 500 MG 71.223 - - - - - -
J1580 - Injection, garamycin, gentamicin, up to 80 mg 80 MG 2.166 - - - - - -
J1596 - Injection, glycopyrrolate, 0.1 mg 0.1 MG 0.375 - - - - - -
J1597 - Injection, glycopyrrolate (glyrx-pf), 0.1 mg 0.1 MG 1.276 - - - - - -
J1598 - Injection, glycopyrrolate (fresenius kabi), not therapeutically equivalent to j1596, 0.1 mg 0.1 MG 1.342 - - - - - -
J1602 - Injection, golimumab, 1 mg, for intravenous use 1 MG 11.631 - - - - - -
J1610 - Injection, glucagon hydrochloride, per 1 mg 1 MG 164.863 - - - - - -
J1611 - Injection, glucagon hydrochloride (fresenius kabi), not therapeutically equivalent to j1610, per 1 mg 1 MG 143.254 - - - - - -
J1626 - Injection, granisetron hydrochloride, 100 mcg 100 MCG 0.146 - - - - - -
J1627 - Injection, granisetron, extended-release, 0.1 mg 0.1 MG 4.298 - - - - - -
J1628 - Injection, guselkumab, 1 mg 1 MG 72.937 - - - - - -
J1630 - Injection, haloperidol, up to 5 mg 5 MG 0.730 - - - - - -
* Effective January 1, 2026 through March 31, 2026

ASP (Average Sale Price) Drug Pricing History