HCPCS J0178

Injection, aflibercept, 1 mg (CMS descriptor)

Drugs Drug code Work RVU per service none (2020 fee schedule; adds 0 work RVUs)

2,954
92nd percentile among 6,116 codes billed · 2020
$2.27B
100th percentile among 6,116 codes billed · 2020
3.1M
98th percentile among 6,116 codes billed · 2020
714
96th percentile among 6,116 codes billed · 2020
3,088
95th percentile among 6,116 codes billed · 2020

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
Florida230$219,435,423296,6579403,706
California267$161,404,029218,5255642,336
Texas198$148,737,927201,7076243,166
New York210$140,993,274191,2175403,062
Pennsylvania130$114,347,796154,6127763,597
Illinois127$98,027,716132,4707682,878
North Carolina86$94,468,071127,9281,1964,018
Virginia71$87,303,149118,2401,3704,076
Maryland92$80,559,856109,3518982,995
Ohio94$74,404,195100,8011,0012,567
Washington76$59,367,64180,3786042,854
New Jersey75$58,862,16979,7558972,517
Massachusetts87$57,666,03877,8185443,169
Michigan108$57,616,90578,2366031,837
Tennessee64$50,040,01568,2989022,439

Not listed: 1 billers with an armed-forces or unknown state code (AE); they are in the national totals.

Not listed: 10 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 2020.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ207$132,217,397179,229538
Chicago-Naperville-Elgin, IL-IN105$78,004,651105,438768
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD60$55,427,39475,034980
Los Angeles-Long Beach-Anaheim, CA94$53,111,14571,799537
Boston-Cambridge-Newton, MA-NH63$46,911,73563,278544
Miami-Fort Lauderdale-West Palm Beach, FL56$42,566,48357,424813
Baltimore-Columbia-Towson, MD50$40,686,95555,282841
Washington-Arlington-Alexandria, DC-VA-MD-WV55$39,430,84253,531634
Dallas-Fort Worth-Arlington, TX45$37,520,48850,961856
Houston-Pasadena-The Woodlands, TX53$33,708,49045,633618
Tampa-St. Petersburg-Clearwater, FL41$31,543,59842,690770
Seattle-Tacoma-Bellevue, WA41$31,108,13542,176640
Raleigh-Cary, NC17$26,386,31135,6931,622
Phoenix-Mesa-Chandler, AZ34$25,085,94433,998716
Atlanta-Sandy Springs-Roswell, GA38$24,065,21632,625813

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 61 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2020.

Specialties billing J0178 nationally

Ophthalmology accounts for 100% of payment for J0178 nationally in 2020, across 1 specialties on claims.

observed calculated calculated calculated calculated calculated
Ophthalmology2,93899%$2,264,150,212100%3,068,3371,044

Not listed: 5 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 2020.

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