J1559 NDC Crosswalk, Billing Units, ASP Payment & Medicare Reimbursement

📋 J1559 summary

J1559 is a HCPCS Level II J-code used to bill immune globulin (hizentra), 100 mg, billed per 100 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 J1559: Hizentra

Code J1559 Billing unit 100 MG Payment limit $14.883/unit NDC-Crosswalk 8 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 codeJ1559

DescriptorInjection, immune globulin (hizentra), 100 mg

Billing unit100 MG

Payment limit / unit$14.883

Est. ASP / unit$14.041 est.

Mapped NDCs8

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

$14.883

Est. ASP / unit

$14.041 est.

Est. after 2% sequester

$14.585

HCPCS dosage

100 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 (hizentra), 100 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 date2011-01-01

Date added2011-01-01

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

🧮 Dosing & billing-units calculator HCPCS UNITS

One billing unit of J1559 = 100 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 J1559 WITH EST. MEDICARE PAY

8 NDCs map to J1559. Bill units = how many HCPCS units one package represents. Est. pay / pkg = payment limit ($14.883/unit) × that package's bill units.

NDC (11-digit)	Drug	Labeler	Package	Strength	Bill units	Est. pay / pkg	NADAC / unit	Status	Source
44206-0451-01	Hizentra HUMAN IMMUNOGLOBULIN G .2 g/mL LIQUID	CSL	1 VIAL, SINGLE-DOSE in 1 CARTON (44206-451...	.2 g/mL	10	$148.83	—	● Active	CMS + PDAC
44206-0452-02	Hizentra HUMAN IMMUNOGLOBULIN G .2 g/mL LIQUID	CSL	1 VIAL, SINGLE-DOSE in 1 CARTON (44206-452...	.2 g/mL	20	$297.66	—	● Active	CMS + PDAC
44206-0454-04	Hizentra HUMAN IMMUNOGLOBULIN G .2 g/mL LIQUID	CSL	1 VIAL, SINGLE-DOSE in 1 CARTON (44206-454...	.2 g/mL	40	$595.32	—	● Active	CMS + PDAC
44206-0455-10	Hizentra HUMAN IMMUNOGLOBULIN G .2 g/mL LIQUID	CSL	1 VIAL, SINGLE-DOSE in 1 CARTON (44206-455...	.2 g/mL	100	$1,488.30	—	● Active	CMS + PDAC
44206-0455-25	Hizentra HUMAN IMMUNOGLOBULIN G .2 g/mL LIQUID	CSL	1 SYRINGE in 1 CARTON (44206-455-25) / 50...	.2 g/mL	100	$1,488.30	—	● Active	CMS + PDAC
44206-0456-21	Hizentra HUMAN IMMUNOGLOBULIN G .2 g/mL LIQUID	CSL	1 SYRINGE in 1 CARTON (44206-456-21) / 5...	.2 g/mL	10	$148.83	—	● Active	CMS + PDAC
44206-0457-22	Hizentra HUMAN IMMUNOGLOBULIN G .2 g/mL LIQUID	CSL	1 SYRINGE in 1 CARTON (44206-457-22) / 10...	.2 g/mL	20	$297.66	—	● Active	CMS + PDAC
44206-0458-24	Hizentra HUMAN IMMUNOGLOBULIN G .2 g/mL LIQUID	CSL	1 SYRINGE in 1 CARTON (44206-458-24) / 20...	.2 g/mL	40	$595.32	—	● Active	CMS + 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 J1559 with… RELATED CODES

Adjacent HCPCS codes that share an ingredient or formulation with J1559. 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 J1559
J1569	Gammagard liquid injection	500 MG	$49.303	Different billing unit — 500 MG vs 100 MG
J1561	Gamunex-c/gammaked	500 MG	$49.014	Different billing unit — 500 MG vs 100 MG
J1459	Inj ivig privigen 500 mg	500 MG	$51.218	Different billing unit — 500 MG vs 100 MG
J1568	Octagam injection	500 MG	$47.056	Different billing unit — 500 MG vs 100 MG
J1554	Inj. asceniv	500 MG	$509.139	Different billing unit — 500 MG vs 100 MG
J1555	Inj cuvitru, 100 mg	100 MG	$18.147	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

$79.43M

Claims

13,119

Beneficiaries

4,783

Spend / beneficiary

$16,606.59

Spend / claim

$6,054.52

Trend by period

Where J1559 ranks among Part B drugs · 2026 (Q1) · neighbors ±5

Total spending — #40 of 824

#35 VYVGART J9332 $103.34M #36 OCTREOTIDE ACETATE E... J2353 $101.31M #37 ACTEMRA(J3262) J3262 $99.7M #38 KYPROLIS J9047 $88.51M #39 INFLIXIMAB* J1745 $82.56M #40 HIZENTRA J1559 $79.43M #41 CIMZIA (2 PACK)* J0717 $79.11M #42 SIMPONI ARIA J1602 $77.87M #43 KRYSTEXXA J2507 $76.71M #44 TEZSPIRE J2356 $75.17M #45 NUCALA J2182 $74.59M

Total claims — #145 of 824

#140 LUCENTIS J2778 13,447 #141 INFED J1750 13,385 #142 GENTAMICIN SULFATE I... J1580 13,327 #143 ALIMTA* J9305 13,253 #144 TECENTRIQ J9022 13,217 #145 HIZENTRA J1559 13,119 #146 IPRATROPIUM BROMIDE J7644 12,953 #147 ERTAPENEM J1335 12,875 #148 ENGERIX-B ADULT(9074... 90746 12,582 #149 PYRIDOXINE HCL J3415 12,475 #150 FULPHILA Q5108 12,305

Full breakdown by period (2)

Period	Total spend	Beneficiaries	Claims	$/beneficiary	$/claim
2026 (Q1)	$79.43M	4,783	13,119	$16,606.59	$6,054.52
2025 (Q1-Q4)	$342.3M	5,375	58,556	$63,684.26	$5,845.74

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

$351.86M

Medicare paid

$276.71M

Submitted services

26,550,587

Denial rate

4.9%

Allowed / service

$13.93

Submitted charges

$1.97B

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.

📊 What bills under J1559

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

HUMAN IMMUNOGLOBULIN G 7

NDC products by labeler

CSL Behring AG 7

🔗 Related NDC directory pages

🧪 All Human Immunoglobulin G NDCsIngredient 🏭 All CSL labeler NDCsLabeler 44206 📚 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)

8 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.

❓ J1559 billing FAQ

What is HCPCS code J1559?

J1559 is a HCPCS Level II J-code used to bill Injection, immune globulin (hizentra), 100 mg under Medicare Part B and most medical (not pharmacy) benefits.

What is the billing unit for J1559?

One unit of J1559 represents 100 MG. Report the number of units equal to the dose administered divided by 100 MG.

How many units of J1559 should I bill?

Divide the dose administered by the code's unit size (100 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 J1559?

The Medicare Part B payment limit is $14.883 per unit (Q3 2026), based on ASP + 6%. After the 2% sequester the effective payment is about $14.585 per unit. Payment limits are revised quarterly.

Which NDCs bill under J1559?

8 NDCs currently map to J1559 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 J1559 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.

J1559 – Injection, immune globulin (hizentra), 100 mg · NDC Crosswalk & Billing Units