J1556 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J1556 summary

J1556 is a HCPCS Level II J-code used to bill immune globulin (bivigam), 500 mg, billed per 500 MG. The number of billing units to report depends on the dose administered and the NDC/package billed — use the calculator below.

Brand names associated with J1556: Bivigam

Code J1556 Billing unit 500 MG Payment limit $81.241/unit NDC-Crosswalk 3 Quarter Q3 2026 RxCUI Atlas Trace the drug concept →

⚠ An NDC↔HCPCS crosswalk and a published payment limit do not guarantee payer coverage or payment. Always verify the current payer policy and claim format before billing.

🗂️ Key billing facts

HCPCS codeJ1556

DescriptorInjection, immune globulin (bivigam), 500 mg

Billing unit500 MG

Payment limit / unit$81.241

Est. ASP / unit$76.642 est.

Mapped NDCs3

Data periodQ3 2026

Last updated2026-08-20

🧾 Billing & reimbursement HCPCS · CMS · EFF. Q3 2026

📅 Payment limits effective Q3 2026 — from the CMS Medicare Part B Payment Limit File (revised quarterly).

Medicare payment limit / unit

$81.241

Est. ASP / unit

$76.642 est.

Est. after 2% sequester

$79.616

HCPCS dosage

500 MG

The CMS payment limit is the Medicare Part B drug allowance (ASP + 6%, statutory). After the 2% federal sequester the effective payment is ≈ ASP + 4.3%; estimated ASP = payment limit ÷ 1.06. Source: CMS Medicare Part B Payment Limit File (quarterly), Q3 2026.

Full HCPCS code details (official CMS record)

Long descriptionInjection, immune globulin (bivigam), 500 mg

CoverageC — Carrier/MAC judgment

Pricing indicator51 — Drug — priced under the ASP methodology

Type of service1 — Medical care

BETOS-2O1E

ASC payment groupYY

Action codeN — No maintenance this year

Effective date2014-01-01

Date added2014-01-01

Source: CMS HCPCS Level II code file (imported via admin).

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J1556 = 500 mg. Enter a regimen to convert dose → billing units and project a full course.

Dose per administration (mg) Frequency — every days Number of doses NDC / package billed (optional)

Billing units = dose ÷ HCPCS unit size. Most payers require whole units — round per the payer's policy. “Est. Medicare pay” uses the current payment limit. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (JZ when none is discarded) where allowed. Always verify payer-specific rounding before billing.

🔁 NDCs that bill under J1556 WITH EST. MEDICARE PAY

3 NDCs map to J1556. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($81.241/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
69800-6502-01	BIVIGAM Immune Globulin Intravenous (Human) 10% 5 g/50mL INJECTION, SOLUTION	ADMA	1 VIAL, SINGLE-USE in 1 CARTON (69800-6502...	5 g/50mL	10	$812.41	—	● Active	CMS + PDAC
69800-6503-01	BIVIGAM Immune Globulin Intravenous (Human) 10% 10 g/100mL INJECTION, SOLUTION	ADMA	1 VIAL, SINGLE-USE in 1 CARTON (69800-6503...	10 g/100mL	20	$1,624.82	—	● Active	CMS + PDAC
59730-6502-01	BIVIGAM (LATEX-FREE) 100 MG/ML	Unknown	—	—	0.2	$16.25	—	—	PDAC

NDC→HCPCS mappings come from the CMS ASP NDC-HCPCS crosswalk; additional DME MAC / DMEPOS mappings come from PDAC and are labeled separately. NADAC from CMS (weekly). “Status” reflects the product's marketing / obsolete flag in the NDC directory. Presence or absence here does not determine Medicare coverage. Linked NDCs open the full product page.

⚠️ Don't confuse J1556 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J1556. Billing units and payment limits differ — confirm the exact code, strength and form before billing.

Code	Descriptor	Billing unit	Payment limit / unit	How it differs from J1556
J1569	Gammagard liquid injection	500 MG	$49.303	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J1561	Gamunex-c/gammaked	500 MG	$49.014	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J1459	Inj ivig privigen 500 mg	500 MG	$51.218	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J1559	Hizentra injection	100 MG	$14.883	Different billing unit — 100 MG vs 500 MG
J1568	Octagam injection	500 MG	$47.056	Related ingredient or formulation — confirm strength, form and billing unit before substituting.
J1554	Inj. asceniv	500 MG	$509.139	Related ingredient or formulation — confirm strength, form and billing unit before substituting.

Related codes matched on shared ingredient (CMS Medicare Part B Spending feed). Billing units and payment limits from the CMS ASP Pricing File. Always verify the precise HCPCS code for the product and strength administered.

📊 Medicare utilization & spend CMS · PART B · 2026 (Q1)

Period

Total Part B spend

$10.79M

Claims

1,700

Beneficiaries

536

Spend / beneficiary

$20,134.23

Spend / claim

$6,348.20

Trend by period

Where J1556 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #175 of 824

#170 GAMMAGARD S-D J1566 $11.36M #171 TREMFYA ONE-PRESS* J1628 $11.31M #172 GEL-ONE J7326 $11.18M #173 ILARIS J0638 $11.05M #174 HYMOVIS ONE* J7322 $10.91M #175 BIVIGAM J1556 $10.79M #176 OCREVUS ZUNOVO J2351 $10.44M #177 DUROLANE J7318 $10.44M #178 OZURDEX J7312 $10.24M #179 BENDEKA J9034 $10.16M #180 INFLECTRA Q5103 $9.98M

Total claims — #332 of 824

#327 ZOLADEX J9202 1,858 #328 DAPTOMYCIN(J0872) J0872 1,843 #329 JEVTANA J9043 1,832 #330 QUZYTTIR J1201 1,770 #331 TOFIDENCE Q5133 1,736 #332 BIVIGAM J1556 1,700 #333 ERIBULIN MESYLATE* J9179 1,689 #334 TYVASO INSTITUTIONAL... J7686 1,683 #335 MONJUVI J9349 1,625 #336 ASCENIV J1554 1,618 #337 DURYSTA J7351 1,581

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$10.79M	536	1,700	$20,134.23	$6,348.20
2025 (Q1-Q4)	$53.8M	1,010	8,822	$53,270.42	$6,098.74

Provider-administered (Part B) spend, calculated for the whole HCPCS code (CMS does not publish Medicare spend per individual NDC). Self-administered use is covered under Part D instead. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part B Spending by Drug (data.cms.gov), updated quarterly.

📈 Medicare Part B claims detail CMS PSPS · 2024

Calendar-year 2024 Medicare Part B fee-for-service activity for this HCPCS code, summed across all carriers, localities and specialties (CMS Physician/Supplier Procedure Summary). A “service” is one billed line/unit — not one claim — so counts run higher than claim counts.

Allowed charges

$54.79M

Medicare paid

$42.85M

Submitted services

762,275

Denial rate

6.6%

Allowed / service

$76.93

Submitted charges

$152.01M

Source: CMS Physician/Supplier Procedure Summary (PSPS), CY2024 — Medicare Part B carrier + DME fee-for-service claims (excludes Medicare Advantage). Figures are for the whole HCPCS code, which may cover uses beyond this drug. ⚠ CMS hides any figure covering fewer than 11 patients (a privacy rule), so totals — especially denials and low-volume codes — run a little low.

🗺️ Where J1556 is utilized CMS · BY PROVIDER · 2024

Medicare Part B services for this code by the rendering provider's state — 429,595 services across 11 states & territories in 2024 (CMS reports include DC and U.S. territories). Switch to per 100k to compare states fairly regardless of population. Hover or tap a state for its top ZIP codes.

Hover or tap a state to see its numbers + top ZIP codes.

Per-capita = services ÷ 2023 state population × 100,000 (so high-population states aren't automatically "hotter"). Counts reflect the provider's location, not the patient's. Providers with fewer than 11 patients are hidden by CMS for privacy, so totals run low and per-100k can be noisy in small states — read this as relative geography, not exact counts. Source: CMS Medicare Physician & Other Practitioners — by Provider and Service, 2024.

📊 What bills under J1556

J-codes are billing codes often used for drugs billed under the medical benefit. This connects the billing code to the NDC package records it covers, by ingredient and labeler.

NDC products by ingredient

Immune Globulin Intravenous (Human... 2

NDC products by labeler

ADMA Biologics, Inc. 2

🔗 Related NDC directory pages

🧪 All Immune Globulin Intravenous (Human) 10% NDCsIngredient 🏭 All ADMA labeler NDCsLabeler 69800 📚 All Human Immunoglobulin G NDCsDrug class

🗃️ Data sources & freshness

Every figure on this page is computed from public datasets. Here's what each section draws on and how current it is.

HCPCS code & descriptor

CMS HCPCS Level II code file

Loaded

Payment limit & billing unit

CMS Medicare Part B ASP Pricing File (quarterly)

Q3 2026 · as of 2026-08-20

NDC ↔ HCPCS crosswalk

CMS ASP NDC-HCPCS crosswalk + DMEPDAC (PDAC)

3 NDCs mapped

NADAC acquisition cost

CMS National Average Drug Acquisition Cost (weekly)

Not available for mapped NDCs

Utilization & spend

CMS Part B Spending by Drug · PSPS · Physician & Other Practitioners

Latest data year 2026

Figures are estimates for reference and may lag the source files. Always verify against the current CMS files and your payer's policy before submitting claims.

⚠️ Practical billing caveats

A crosswalk is not coverage. An NDC mapping or a published payment limit does not guarantee a payer will cover or pay this code. Check the specific plan's policy.
Units ≠ milligrams. Bill the number of HCPCS units (dose ÷ the code's unit size), not the milligram dose. Use the calculator above.
Discarded drug. For single-dose vials, drug discarded after administration may be separately billable with modifier JW (and JZ when nothing is discarded) where the payer allows.
Rounding & partial units. Many payers require whole units; round per the payer's policy, not automatically up.
The code can cover more than this drug. Some HCPCS codes span multiple products or strengths — confirm the exact code for the product administered.
Figures lag. ASP limits change quarterly and utilization data are released with a delay. Verify against the current CMS files before billing.

❓ J1556 billing FAQ

What is HCPCS code J1556?

J1556 is a HCPCS Level II J-code used to bill Injection, immune globulin (bivigam), 500 mg under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J1556?

One unit of J1556 represents 500 MG. Report the number of units equal to the dose administered divided by 500 MG.

How many units of J1556 should I bill?

Divide the dose administered by the code's unit size (500 MG) to get the number of billing units, then round per your payer's policy. The calculator on this page converts a dose into billing units and projects a full course.

How much does Medicare pay for J1556?

The Medicare Part B payment limit is $81.241 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $79.616 per unit. Payment limits are revised quarterly.

Which NDCs bill under J1556?

3 NDCs currently map to J1556 in the CMS ASP NDC-HCPCS crosswalk. See the NDC crosswalk table above for each product, package, billing units and estimated reimbursement.

Does a crosswalk mean J1556 is covered?

No. An NDC-to-HCPCS crosswalk and a published payment limit do not guarantee coverage or payment. Coverage depends on the payer, the diagnosis and the site of care — always verify the current policy before billing.

J1556 – Injection, immune globulin (bivigam), 500 mg · NDC Crosswalk & Billing Units