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Infusion Therapy Drug Calculator

Enter the prescription information to calculate the units of service.

Hizentra - J1559

Bill 1 UOS per 100mg

Grams Ordered (g):
Number of Infusions Dispensed:

Gammagard Liquid - J1569

Bill 1 UOS per 500mg

Grams ordered (g):
Number of Infusions Dispensed:

HyQvia - J1575

Bill 1 UOS per 100mg

Grams ordered (g):
Number of Infusions Dispensed:

Refer to the External Infusion Pumps Local Coverage Determination (LCD) (L33794)External Website and External Infusion Pumps - Policy Article (A52507)External Website for coverage guidance, and coding information, documentation requirements, and other payment rules.

Disclaimer: CGS' online tools and calculators are informational and educational tools only, designed to assist suppliers and providers in submitting claims correctly. CGS makes no guarantee that this resource will result in Medicare reimbursement for services provided. Although we've made every reasonable effort to provide effective resources, CGS is not responsible for the consequences of any decisions or actions taken in reliance upon or as a result of the information that these tools provide. CGS is not responsible for any human or mechanical errors or omissions.

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