HCPCS J0178

Injection, aflibercept, 1 mg (CMS descriptor)

Drugs Drug code Work RVU per service none (2021 fee schedule; adds 0 work RVUs)

3,037
92nd percentile among 6,253 codes billed · 2021
$2.60B
100th percentile among 6,253 codes billed · 2021
3.5M
98th percentile among 6,253 codes billed · 2021
808
96th percentile among 6,253 codes billed · 2021
3,351
95th percentile among 6,253 codes billed · 2021
+14.4%
Medicare payment on the code vs 2020; billers +2.8% · 2021

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
Florida243$231,063,960315,0588843,673
California287$204,808,265278,1386802,973
New York217$168,082,478230,3356943,230
Texas205$162,514,228222,4156683,200
Pennsylvania138$132,057,570180,2239113,766
Illinois127$112,198,841152,5538953,298
North Carolina92$103,651,172141,6851,2933,765
Virginia71$97,917,326134,2381,5984,200
Maryland89$89,851,589122,9799743,664
Ohio91$85,443,852116,7001,1863,006
Massachusetts89$72,077,32097,6027123,236
Michigan118$70,199,37895,6906122,245
Washington82$67,776,84592,2806672,904
New Jersey71$66,692,74191,1701,1882,659
Indiana60$59,624,04981,1468413,408

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 2021.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ208$162,001,966221,665713
Chicago-Naperville-Elgin, IL-IN103$91,525,313124,494995
Los Angeles-Long Beach-Anaheim, CA96$68,991,72893,706779
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD63$65,015,13188,7961,104
Boston-Cambridge-Newton, MA-NH65$57,968,54978,506712
Washington-Arlington-Alexandria, DC-VA-MD-WV59$47,529,72765,145700
Miami-Fort Lauderdale-West Palm Beach, FL64$47,108,57664,005604
Baltimore-Columbia-Towson, MD44$41,785,30057,318958
Dallas-Fort Worth-Arlington, TX46$41,730,36957,231635
Houston-Pasadena-The Woodlands, TX54$40,925,67155,896899
Tampa-St. Petersburg-Clearwater, FL43$36,498,83549,832814
Seattle-Tacoma-Bellevue, WA43$35,086,97047,754644
Detroit-Warren-Dearborn, MI50$30,191,57341,161646
Phoenix-Mesa-Chandler, AZ34$29,076,35839,445974
Atlanta-Sandy Springs-Roswell, GA36$27,972,90438,3041,085

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 59 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2021.

Specialties billing J0178 nationally

Ophthalmology accounts for 100% of payment for J0178 nationally in 2021, across 1 specialties on claims.

observed calculated calculated calculated calculated calculated
Ophthalmology3,01899%$2,591,256,755100%3,537,1961,172

Not listed: 6 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 2021.

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