CPT J1572
Global XXXFlebogamma injection
This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.
CPT J1572 Billing & Documentation Guide
CPT code J1572 (Flebogamma injection) is classified under Unclassified with a global period indicator of XXX. This code uses the No national RVU payment methodology rather than standard RVU-based Physician Fee Schedule pricing. Refer to the methodology notice above for billing implications.
When billing J1572, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify current NCCI edits before bundling with related codes.
Payment Status & Global Period
Excluded from MPFS by regulation
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 180 units of J1572 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
Frequently Asked Questions, CPT J1572
What does CPT code J1572 mean? +
CPT code J1572 represents: Injection, immune globulin, (flebogamma/flebogamma dif), intravenous, non-lyophilized (e.g., liquid), 500 mg. It's in the category with a global period of XXX.
What is the Medicare reimbursement for CPT J1572? +
This code does not have a national work RVU on the current Physician Fee Schedule. Pricing may be carrier-determined, non-covered, or tracked via a separate methodology.
What modifiers can I use with CPT J1572? +
Applicable modifiers depend on the specific service type. Refer to the CPT codebook section guidelines for this code range.
What bundling edits apply to CPT J1572? +
No NCCI PTP edits currently on file for this code.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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