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See a sample rate comparisonHCPCS J1559 (Hizentra) 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 (Hizentra), 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 |
| Complexity Level | Low |
| Medicaid Fee Schedule | View Medicaid rates for J1559 |
| Medicare Payment Limit | $14.337  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 44206-0451-01 - HIZENTRA (SINGLE-USE VIAL,PF) 20% • 44206-0452-02 - HIZENTRA (SINGLE-USE VIAL,PF) 20% • 44206-0454-04 - HIZENTRA (SINGLE-USE VIAL,PF) 20% • 44206-0455-10 - HIZENTRA (SINGLE-USE VIAL,PF) 20% • 44206-0455-25 - HIZENTRA (SINGLE-USE,PF) 20% |
National average reimbursement for HCPCS J1559 by major payers:
$14.79
$14.50
$14.82
$14.18
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HCPCS J1559
5 of 25 sample ratesHigher to lower in this preview
Guillermo Rodriguez
Washington University Physicians In Illinois Inc
$24.45Published rateJodi Selzer
$18.97Published rateSylwia Nowak
Allergy Asthma Medical Associates Ltd
$14.94Published rateRogerio Lilenbaum
Comprehensive Cancer Centers Inc
$13.64Published rateMichael Parry
Stamford Health Medical Group Inc
$12.27Published rate
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See a sample payer proposalHCPCS J1559 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1559 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 J1559 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 |
|---|---|---|
| 44206-0451-01-NDC | Moderate | HIZENTRA (SINGLE-USE VIAL,PF) 20% |
| 44206-0452-02-NDC | Moderate | HIZENTRA (SINGLE-USE VIAL,PF) 20% |
| 44206-0454-04-NDC | Moderate | HIZENTRA (SINGLE-USE VIAL,PF) 20% |
| J1559-HCPCS | Low | Injection, immune globulin (Hizentra), 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 J1559. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1559 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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