HCPCS J0178

Injection, aflibercept, 1 mg (CMS descriptor)

Drugs Drug code Work RVU per service none (2024 fee schedule; adds 0 work RVUs)

3,155
93rd percentile among 6,471 codes billed · 2024
$1.76B
100th percentile among 6,471 codes billed · 2024
2.7M
98th percentile among 6,471 codes billed · 2024
559
94th percentile among 6,471 codes billed · 2024
2,586
93rd percentile among 6,471 codes billed · 2024
-25.4%
Medicare payment on the code vs 2023; billers -1.5% · 2024

Trend

Medicare payment on the code

$0$1.00B$2.00B2020: $2.27B paid20202021: $2.60B paid20212022: $2.65B paid20222023: $2.35B paid20232024: $1.76B paid2024$1.76B$0$1.00B$2.00B2020: $2.27B paid20202021: $2.60B paid20212022: $2.65B paid20222023: $2.35B paid20232024: $1.76B paid2024$1.76B$0$1.00B$2.00B2020: $2.27B paid20202021: $2.60B paid20212022: $2.65B paid20222023: $2.35B paid20232024: $1.76B paid2024$1.76B$0$1.00B$2.00B2020: $2.27B paid20202021: $2.60B paid20212022: $2.65B paid20222023: $2.35B paid20232024: $1.76B paid2024$1.76B

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

Billers

02,0002020: 2,954 providers20202021: 3,037 providers20212022: 3,143 providers20222023: 3,204 providers20232024: 3,155 providers20243,15502,0002020: 2,954 providers20202021: 3,037 providers20212022: 3,143 providers20222023: 3,204 providers20232024: 3,155 providers20243,15502,0002020: 2,954 providers20202021: 3,037 providers20212022: 3,143 providers20222023: 3,204 providers20232024: 3,155 providers20243,15502,0002020: 2,954 providers20202021: 3,037 providers20212022: 3,143 providers20222023: 3,204 providers20232024: 3,155 providers20243,155

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

observed calculated calculated calculated calculated calculated reported
20243,155$1,756,326,820-25%2,690,6165592,5860.00
20233,204$2,354,722,372-11%3,427,4587223,1340.00
20223,143$2,653,616,697+2%3,716,3268223,4450.00
20213,037$2,598,280,485+14%3,546,8458083,3510.00
20202,954$2,270,531,860first year in data3,076,9477143,0880.00

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Data years 2020–2024.

By state

observed calculated calculated calculated calculated calculated
California310$156,484,352239,2035012,307
Florida231$152,682,430233,4047362,821
New York229$121,291,871185,6174842,410
Texas222$105,402,020161,5704382,248
Pennsylvania138$100,350,526153,1697913,323
Illinois120$67,337,915103,0785812,727
Massachusetts86$64,307,54598,0136553,356
Virginia80$60,735,06592,7688233,350
North Carolina90$58,190,38889,0716602,747
Michigan114$56,104,72685,9734562,013
Maryland101$53,100,56081,3435972,411
Ohio105$52,634,32182,7455582,021
Indiana68$43,040,47365,9746102,838
Tennessee74$39,672,40960,8765462,211
Georgia62$38,735,69259,5308172,612

Not listed: 2 billers with an armed-forces or unknown state code (AE, ZZ); they are in the national totals.

Not listed: 11 states with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Providers placed by practice address. Data year 2024.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ235$101,058,598154,490430
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD67$58,358,95089,114958
Chicago-Naperville-Elgin, IL-IN100$57,430,59787,865655
Los Angeles-Long Beach-Anaheim, CA117$51,904,67179,379422
Boston-Cambridge-Newton, MA-NH60$49,732,38275,771630
Houston-Pasadena-The Woodlands, TX66$35,735,22754,793604
Miami-Fort Lauderdale-West Palm Beach, FL56$32,164,53649,050634
Washington-Arlington-Alexandria, DC-VA-MD-WV68$28,705,51143,981441
Detroit-Warren-Dearborn, MI50$28,092,04443,033460
Dallas-Fort Worth-Arlington, TX47$25,451,60339,020526
Baltimore-Columbia-Towson, MD48$24,632,72237,830627
Tampa-St. Petersburg-Clearwater, FL42$24,216,68837,135633
Atlanta-Sandy Springs-Roswell, GA42$22,402,88534,402692
Minneapolis-St. Paul-Bloomington, MN-WI33$22,011,47133,588640
Kansas City, MO-KS23$20,516,62231,5411,056

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 64 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2024.

Specialties billing J0178 nationally

Ophthalmology accounts for 100% of payment for J0178 nationally in 2024, across 1 specialties on claims.

observed calculated calculated calculated calculated calculated
Ophthalmology3,141100%$1,750,106,817100%2,681,136854

Not listed: 7 specialties with fewer than 11 billers (small cells).

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). Provider-level lines (fewer than 11 beneficiaries suppressed by CMS); specialty is the provider type on claims. Data year 2024.

Top billers of J0178 nationally

Named top billers are a Pro figure, and Pro is not available to buy, so this list is not shown to any account. The counts and totals by state, metro area and specialty on this page are free.

Original Medicare Part B fee-for-service only; CMS suppresses provider lines with fewer than 11 beneficiaries. How these figures are computed · Limitations