HCPCS Code Details - J1569

HCPCS Level II Code
Drugs administered other than oral method, chemotherapy drugs
HCPCS Code J1569
Description

Long description:
Injection, immune globulin, (gammagard liquid/gammagard liquid erc), 500 mg

Short description:
Gammagard liquid/erc inj

HCPCS Modifier1
HCPCS Pricing indicator 51 - Drugs
Multiple pricing indicator A - Not applicable as HCPCS priced under one methodology
Coverage code D - Special coverage instructions apply
ASC payment group code Effective Jan 01, 2008 - This procedure is approved to be performed in an ambulatory surgical center.
BETOS2 code O1E - Other drugs
HCPCS Action code C - Change in long description of procedure or modifier code
Type of service 1 - Medical care
Effective date Effective Jul 01, 2026
Date added Added Jan 01, 2008
HCPCS Coding Procedures

HCPCS Modifiers

In HCPCS Level II, modifiers are composed of two alpha or alphanumeric characters.

Example: E0260-NU - Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress
NU” identifies the hospital bed as new equipment

ASP Drug pricing - J1569

Effective Code Dosage Payment
Limit
Vaccine AWP % Vaccine Limit Infusion AWP % DME infusion limit Blood AWP % Blood limit Clotting factor Note
Jul 1, 2026 - Sep 30, 2026 500 MG 49.303 - - - - - -
April 1, 2026 - June 30, 2026 500 MG 49.081 - - - - - -
January 1, 2026 - March 31, 2026 500 MG 47.288 - - - - - -
October 1, 2025 - December 31, 2025 500 MG 45.314 - - - - - -
Jul 1, 2025 - Sep 30, 2025 500 MG 47.797 - - - - - -

See also

  • HCPCS J1557 · Injection, immune globulin, (gammaplex), intravenous, non-lyophilized (e.g., liquid), 500 mg

  • HCPCS J1561 · Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg

  • HCPCS J1566 · Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg

  • HCPCS J1568 · Injection, immune globulin, (octagam), intravenous, non-lyophilized (e.g., liquid), 500 mg

  • HCPCS J1572 · Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg

  • HCPCS J1599 · Injection, immune globulin, intravenous, non-lyophilized (e.g., liquid), not otherwise specified, 500 mg

  • HCPCS J1570 · Injection, ganciclovir sodium, 500 mg


1 Two-digit numeric codes are Level I code modifiers copyrighted© by the American Medical Association's Current Procedural Terminology (CPT).

2 BETOS stands for “Berenson-Eggers Type Of Service”