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See a sample rate comparisonHCPCS J1566 (Gammagard S D) Fee Schedule
Medicare rates as of October 2026
HCPCS J1566 is classified under Drugs Administered Other than Oral Method, in the Drugs, Administered by Injection subgroup.
Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg
| Key Fact | Detail |
|---|---|
| Service Type | Drugs Administered Other than Oral Method Drugs, Administered by Injection |
| Common Place of Service | 99 - Other POS |
| Complexity Level | Low |
| Medicare Fee Schedule | $82.76 per 500 mg (October 2026 ASP) · View Medicare rates for J1566 |
| Medicaid Fee Schedule | $80.96 median of the 8 states in the free preview · View Medicaid rates for J1566 |
| Medicare Payment Limit | $78.795  |
| WAC Price | Lorem ipsum dolor sit amet consectetur Lorem ipsum dolor sit amet consectetur VisitBuyandBill.com |
| Related NDC Codes | • 00944-2656-03 - GAMMAGARD S/D (IGA<1UG/ML) (SINGLE DOSE) 5 GM • 00944-2658-04 - GAMMAGARD S/D (IGA<1UG/ML) 10 GM • 52769-0470-72 - POLYGAM (W/50 ML DILUENT) 2.5 MG |
National average reimbursement for HCPCS J1566 by major payers:
$89.91
BCBS / Anthem
$88.10
UnitedHealthcare
$89.64
Aetna
$87.08
Cigna
Compare published rates across providers.
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HCPCS J1566
5 of 25 sample ratesHigher to lower in this preview
Nudrat Ayub
Atlantic Health System Inc
$99.79Published rateSylva Takvorian
Hackensack Meridian Health Medical Group-Specialty Care PC
$85.91Published rateAndrew Matthews
$81.43Published rateKishore Ratkalkar
Medical Associates Of Central
$79.90Published rateMekhala Mathure
Mekhala Mathure Md LLC
$69.22Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS J1566 vs. Other Drugs, Administered by Injection Codes
The table lists codes related to J1566. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 00944-2656-03-NDC | Moderate | GAMMAGARD S/D (IGA<1UG/ML) (SINGLE DOSE) 5 GM |
| 00944-2658-04-NDC | Moderate | GAMMAGARD S/D (IGA<1UG/ML) 10 GM |
| 52769-0470-72-NDC | Moderate | POLYGAM (W/50 ML DILUENT) 2.5 MG |
| J1566-HCPCS | Low | Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 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 J1566. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the J1566 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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