Cost analysis for CPT J1569 — Injection, immune globulin, (gammagard liquid), non-lyophilized, (e.g., liquid), 500 mg
Average Medicare Payment
$35.43
2023 data
Total Payments (2023)
$98.1M
Services (2023)
2.8M
Price Change (2014–2023)
+16.2%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $30.48 | $16.9M | 554.2K | — |
| 2015 | $30.05 | $14.9M | 496.2K | -1.4% |
| 2016 | $30.10 | $15.1M | 506.1K | +0.2% |
| 2017 | $31.04 | $33.9M | 1.1M | +3.1% |
| 2018 | $32.68 | $46.7M | 1.4M | +5.3% |
| 2019 | $31.42 | $62.4M | 2.0M | -3.9% |
| 2020 | $32.16 | $64.9M | 2.0M | +2.4% |
| 2021 | $35.87 | $68.6M | 1.9M | +11.5% |
| 2022 | $35.47 | $72.7M | 2.0M | -1.1% |
| 2023 | $35.43 | $98.1M | 2.8M | -0.1% |
The most expensive state pays 1.0x more than the cheapest for this procedure. NM averages $35.90 vs MN at $34.88.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NM | $35.90 | $102.7K | 2.9K | 2 |
| LA | $35.83 | $190.4K | 5.3K | 1 |
| CO | $35.80 | $131.1K | 3.7K | 1 |
| VT | $35.79 | $147.8K | 4.1K | 1 |
| CA | $35.78 | $11.5M | 322.3K | 38 |
| NC | $35.77 | $1.8M | 51.2K | 14 |
| NJ | $35.76 | $1.3M | 37.3K | 12 |
| ME | $35.75 | $869.5K | 24.3K | 6 |
| MD | $35.74 | $1.8M | 51.1K | 9 |
| KS | $35.73 | $979.6K | 27.4K | 5 |
| FL | $35.71 | $23.3M | 651.2K | 132 |
| CT | $35.70 | $568.0K | 15.9K | 3 |
| IN | $35.68 | $79.9K | 2.2K | 1 |
| NE | $35.67 | $2.0M | 56.6K | 9 |
| GA | $35.67 | $950.5K | 26.6K | 4 |
| AZ | $35.65 | $3.2M | 91.1K | 40 |
| ID | $35.63 | $213.4K | 6.0K | 1 |
| IA | $35.60 | $1.5M | 41.3K | 11 |
| OH | $35.58 | $3.5M | 97.4K | 17 |
| TX | $35.56 | $9.6M | 269.2K | 22 |
| VA | $35.55 | $3.4M | 95.4K | 25 |
| WI | $35.55 | $605.5K | 17.0K | 3 |
| IL | $35.52 | $6.4M | 181.2K | 45 |
| SC | $35.52 | $3.2M | 90.9K | 20 |
| MI | $35.52 | $2.2M | 61.1K | 11 |
| AL | $35.49 | $1.8M | 50.5K | 10 |
| AR | $35.46 | $1.6M | 44.1K | 13 |
| PA | $35.44 | $2.2M | 60.7K | 9 |
| TN | $35.42 | $4.7M | 133.5K | 27 |
| MO | $35.33 | $2.2M | 63.0K | 13 |
| NY | $34.98 | $2.2M | 64.0K | 8 |
| OK | $34.97 | $1.9M | 53.9K | 15 |
| MN | $34.88 | $1.9M | 55.0K | 14 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Igor Cherches | Neurology | TX | $5.8M | 160.9K | $35.75 |
| Dale Prokupek | Gastroenterology | CA | $1.7M | 48.0K | $35.89 |
| Dignity Health | Pharmacy | CA | $1.5M | 42.2K | $35.76 |
| Natan Shaoulian | Neurology | CA | $1.3M | 34.8K | $36.27 |
| Pantelis Pavlakis | Neurology | NY | $1.0M | 29.3K | $34.74 |
| Raam Sambandam | Neurology | FL | $986.5K | 27.6K | $35.70 |
| Stephanie Melton | Nurse Practitioner | OH | $776.7K | 21.7K | $35.76 |
| Andrew Gordon | Neurology | IL | $756.8K | 21.6K | $35.02 |
| Jennifer Douglas | Physician Assistant | SC | $725.1K | 20.2K | $35.83 |
| Thu Tran | Nurse Practitioner | CA | $709.4K | 19.9K | $35.70 |
| Ralph Boccia | Hematology-Oncology | MD | $672.5K | 18.8K | $35.76 |
| Stefano Tarantolo | Medical Oncology | NE | $609.2K | 17.1K | $35.60 |
| Andrea Gillon | Nurse Practitioner | MI | $594.2K | 16.7K | $35.64 |
| Angela Hightower | Nurse Practitioner | TN | $561.6K | 15.7K | $35.77 |
| Hyatt Degreen | Medical Oncology | PA | $536.0K | 15.0K | $35.74 |
| Cheryl Mcdonald | Infectious Disease | TX | $533.5K | 14.9K | $35.71 |
| Abbas Mehdi | Neurology | CA | $531.8K | 15.0K | $35.52 |
| Dexter Estrada | Hematology-Oncology | CA | $518.3K | 14.5K | $35.80 |
| Gadi Avshalomov | Allergy/ Immunology | NY | $493.6K | 13.7K | $36.03 |
| Richard Furie | Rheumatology | NY | $489.4K | 13.7K | $35.72 |
Based on the data, CPT J1569 shows a 1.0x variation in pricing across states — relatively consistent by Medicare standards.
Costs have increased 16.2% 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.