Cost analysis for CPT J1561 — Injection, immune globulin, (gamunex-c/gammaked), non-lyophilized (e.g., liquid), 500 mg
Average Medicare Payment
$36.25
2023 data
Total Payments (2023)
$53.6M
Services (2023)
1.4M
Price Change (2014–2023)
+16.9%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $31.00 | $24.3M | 782.9K | — |
| 2015 | $31.08 | $28.6M | 921.4K | +0.3% |
| 2016 | $31.69 | $27.0M | 853.8K | +2.0% |
| 2017 | $27.90 | $18.4M | 656.8K | -12.0% |
| 2018 | $30.64 | $46.7M | 1.5M | +9.8% |
| 2019 | $29.80 | $47.3M | 1.6M | -2.7% |
| 2020 | $31.79 | $47.6M | 1.5M | +6.7% |
| 2021 | $36.61 | $53.4M | 1.4M | +15.2% |
| 2022 | $34.26 | $47.9M | 1.4M | -6.4% |
| 2023 | $36.25 | $53.6M | 1.4M | +5.8% |
The most expensive state pays 1.1x more than the cheapest for this procedure. SD averages $38.62 vs SC at $35.62.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| SD | $38.62 | $54.8K | 1.4K | 1 |
| WI | $38.41 | $1.1M | 29.2K | 5 |
| AZ | $38.41 | $2.1M | 54.0K | 2 |
| FL | $38.34 | $1.1M | 27.4K | 2 |
| CO | $38.26 | $1.6M | 40.6K | 3 |
| TX | $38.23 | $21.2M | 555.7K | 16 |
| CA | $38.21 | $3.5M | 91.5K | 25 |
| MD | $38.17 | $427.9K | 11.2K | 1 |
| NC | $38.14 | $1.7M | 45.6K | 14 |
| AR | $38.12 | $3.0M | 79.5K | 14 |
| IL | $38.06 | $318.5K | 8.4K | 2 |
| MO | $38.01 | $2.7M | 71.0K | 31 |
| MN | $37.99 | $394.6K | 10.4K | 1 |
| IA | $37.93 | $683.4K | 18.0K | 4 |
| NY | $37.59 | $8.5M | 225.0K | 36 |
| WA | $37.55 | $458.9K | 12.2K | 2 |
| NJ | $37.50 | $300.8K | 8.0K | 3 |
| MI | $37.35 | $745.4K | 20.0K | 1 |
| AL | $37.15 | $274.6K | 7.4K | 1 |
| GA | $37.01 | $296.9K | 8.0K | 1 |
| OH | $36.90 | $2.1M | 57.4K | 7 |
| SC | $35.62 | $1.0M | 28.8K | 7 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Guy Burrows | Neurology | TX | $10.8M | 282.5K | $38.36 |
| Bela Ajtai | Neurology | NY | $1.6M | 42.6K | $38.19 |
| Philip Blum | Neurology | TX | $1.6M | 42.2K | $38.30 |
| Robert Zajac | Infectious Disease | TX | $1.5M | 38.5K | $38.53 |
| James Barry | Neurology | TX | $1.4M | 37.3K | $37.94 |
| Michael Manning | Allergy/ Immunology | AZ | $1.4M | 35.8K | $38.59 |
| David Amran | Allergy/ Immunology | TX | $942.9K | 24.9K | $37.83 |
| Jodie Gallegos | Nurse Practitioner | CO | $897.9K | 23.5K | $38.17 |
| Alan Martin | Neurology | TX | $855.4K | 22.3K | $38.29 |
| Jennifer Desmond | Nurse Practitioner | TX | $784.9K | 20.4K | $38.40 |
| Martin Belkin | Neurology | MI | $745.4K | 20.0K | $37.35 |
| Robert Gelfand | Hematology-Oncology | NY | $742.3K | 19.4K | $38.36 |
| Yessar Hussain | Neurology | TX | $708.9K | 18.4K | $38.51 |
| Erik Ortega | Neurology | AZ | $689.8K | 18.1K | $38.07 |
| Alan Koterba | Allergy/ Immunology | FL | $652.1K | 17.0K | $38.34 |
| Alyssa Rehm | Neurology | NY | $639.3K | 16.8K | $38.12 |
| Jeffrey Weber | Gastroenterology | WI | $633.1K | 16.4K | $38.56 |
| Ralph Round | Neurology | CO | $595.9K | 15.5K | $38.40 |
| Armistead Williams | Nephrology | NY | $577.5K | 15.0K | $38.40 |
| Aliya Khan | Rheumatology | OH | $565.5K | 14.8K | $38.25 |
Based on the data, CPT J1561 shows a 1.1x variation in pricing across states — relatively consistent by Medicare standards.
Costs have increased 16.9% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.