What is the standard insurance baseline for HCPCS J1566?

The standard insurance baseline reimbursement rate is $75.97. This represents the customary allowable amount established across standard fee schedules.

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HCPCS J1566Medical Service

Injection Immune Globulin Intravenous Lyophilized E G Powder Not Otherwise Specified 500 Mg

Q: What do doctors typically charge for Injection Immune Globulin Intravenous Lyophilized E G Powder Not Otherwise Specified 500 Mg?

The nationwide median physician charge for Injection Immune Globulin Intravenous Lyophilized E G Powder Not Otherwise Specified 500 Mg (HCPCS J1566) is $100.00. Doctor billed charges vary based on geographic region, setting, and overhead.

Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg. Clinical pricing breakdown and utilization metrics across 1 practicing doctors nationwide.

$100.00

Peer Median Charge

Gross billed rate

$75.97

Standard Baseline

Customary allowable

1.3x

National Markup

Charge vs baseline

Active Physicians

Billing this code

Planning care or already received a bill for CPT J1566?Calculate total facility bundle costs or generate an assertive dispute settlement offer.

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $100.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $75.97 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code J1566 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"