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See a sample rate comparisonHCPCS J1558 (Xembify) Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Injection, immune globulin (xembify), 100 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | None 99 - Other POS 11 - Office |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1558 |
| Medicare Payment Limit | $14.845  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 13533-0810-05 - XEMBIFY (1GM,PF,LATEX-FREE) 200 MG/1 ML • 13533-0810-10 - XEMBIFY (2GM,PF,LATEX-FREE) 200 MG/1 ML • 13533-0810-20 - XEMBIFY (4GM,PF,LATEX-FREE) 200 MG/1 ML • 13533-0810-50 - XEMBIFY (10GM,PF,LATEX-FREE) 200 MG/1 ML |
National average reimbursement for HCPCS J1558 by major payers:
$15.90
$15.30
$15.99
$15.22
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HCPCS J1558
5 of 25 sample ratesHigher to lower in this preview
Denton Digestive Institute PLLC
$15.68Published rateKuy Houser
St Joseph Regional Health Center
$15.25Published rateAnupama Kapadia
Seton Family Of Doctors
$15.25Published rateOral James
Northwest Florida Multispecialty Physicians LLC
$13.62Published ratePrimary Care Service Evolution LLC
$10.64Published rate
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See a sample payer proposalHCPCS J1558 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1558 code is part of the Drugs Administered Other than Oral Method services used for Drugs, Administered by Injection. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS J1558 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 13533-0810-05-NDC | Moderate | XEMBIFY (1GM,PF,LATEX-FREE) 200 MG/1 ML |
| 13533-0810-10-NDC | Moderate | XEMBIFY (2GM,PF,LATEX-FREE) 200 MG/1 ML |
| 13533-0810-20-NDC | Moderate | XEMBIFY (4GM,PF,LATEX-FREE) 200 MG/1 ML |
| J1558-HCPCS | Low | Injection, immune globulin (xembify), 100 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1558. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1558 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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