HCPCS J0178

Injection, aflibercept, 1 mg (CMS descriptor)

Drugs Drug code Work RVU per service none (2022 fee schedule; adds 0 work RVUs)

3,143
93rd percentile among 6,326 codes billed · 2022
$2.65B
100th percentile among 6,326 codes billed · 2022
3.7M
98th percentile among 6,326 codes billed · 2022
822
96th percentile among 6,326 codes billed · 2022
3,445
95th percentile among 6,326 codes billed · 2022
+2.1%
Medicare payment on the code vs 2021; billers +3.5% · 2022

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
Florida246$233,362,511326,1291,0083,949
California308$225,294,554315,2826683,162
Texas219$177,371,987248,2736704,138
New York223$174,506,991244,2406503,326
Pennsylvania148$128,572,550179,7327813,595
Illinois130$109,643,860153,4228343,122
North Carolina93$98,736,618138,2141,1323,642
Virginia69$95,128,784133,2071,9344,284
Maryland94$91,567,277128,3799713,715
Ohio97$81,406,410115,0811,0862,855
Massachusetts87$73,661,682102,8147683,683
Michigan117$73,148,885102,4906722,510
Washington87$67,214,52294,3366843,234
New Jersey78$66,241,94392,5801,1252,624
Tennessee67$62,623,76288,3321,1503,068

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

Not listed: 7 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 2022.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ218$168,449,858235,623689
Chicago-Naperville-Elgin, IL-IN107$91,904,631128,520942
Los Angeles-Long Beach-Anaheim, CA108$73,646,405102,879665
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD70$68,289,12195,541936
Boston-Cambridge-Newton, MA-NH62$58,348,92481,485680
Houston-Pasadena-The Woodlands, TX59$55,522,00077,6041,026
Washington-Arlington-Alexandria, DC-VA-MD-WV60$51,552,83972,251859
Miami-Fort Lauderdale-West Palm Beach, FL64$48,853,47967,938626
Dallas-Fort Worth-Arlington, TX52$43,766,07361,429670
Baltimore-Columbia-Towson, MD46$42,487,08059,6691,023
Seattle-Tacoma-Bellevue, WA45$36,361,58451,052732
Detroit-Warren-Dearborn, MI48$35,383,45949,533868
Tampa-St. Petersburg-Clearwater, FL44$34,068,48847,706745
Phoenix-Mesa-Chandler, AZ38$32,267,92344,953975
Minneapolis-St. Paul-Bloomington, MN-WI28$31,032,40743,2811,270

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 2022.

Specialties billing J0178 nationally

Ophthalmology accounts for 100% of payment for J0178 nationally in 2022, across 1 specialties on claims.

observed calculated calculated calculated calculated calculated
Ophthalmology3,12799%$2,645,665,182100%3,705,2081,185

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 2022.

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