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See a sample rate comparisonHCPCS J1560 (Gamastan) Fee Schedule
Last Verified: October 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, gamma globulin, intramuscular, over 10 cc
| 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 | Moderate |
| Medicaid Fee Schedule | View Medicaid rates for J1560 |
| Medicare Payment Limit | $170.476  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
National average reimbursement for HCPCS J1560 by major payers:
$470.02
$506.75
$524.74
$525.09
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HCPCS J1560
5 of 25 sample ratesHigher to lower in this preview
University Of California San Francisco Medical Center, Ucsf Medical Center
$934.48Published rateTouro Infirmary
$530.75Published rateAsheville Vamc
$498.51Published rateSoutheast Health Center Of Stoddard County, LLC, Mercy Hospital Stoddard
Southeast Health Center Of Stoddard County LLC
$493.83Published rateBrookdale Hospital Medical Center, Brookdale Emergency Physicians Associates
Brookdale Hospital Medical Center
$45.08Published rate
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See a sample payer proposalHCPCS J1560 vs. Other Drugs, Administered by Injection Codes
The HCPCS J1560 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 J1560 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 |
|---|---|---|
| J1559-HCPCS | Low | Injection, immune globulin (Hizentra), 100 mg |
| J1560-HCPCS | Moderate | Injection, gamma globulin, intramuscular, over 10 cc |
| J1561-HCPCS | Low | Injection, immune globulin, (Gamunex-C/Gammaked), non-lyophilized (e.g., liquid), 500 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J1560. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1560 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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