HCPCS J0178

Injection, aflibercept, 1 mg (CMS descriptor)

Drugs Drug code Work RVU per service none (2023 fee schedule; adds 0 work RVUs)

3,204
93rd percentile among 6,405 codes billed · 2023
$2.35B
100th percentile among 6,405 codes billed · 2023
3.4M
98th percentile among 6,405 codes billed · 2023
722
95th percentile among 6,405 codes billed · 2023
3,134
94th percentile among 6,405 codes billed · 2023
-11.3%
Medicare payment on the code vs 2022; billers +1.9% · 2023

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
Florida250$204,411,477296,7798043,742
California310$200,608,455291,6535692,832
New York230$159,380,079231,6515583,292
Texas212$147,313,291214,1396062,971
Pennsylvania140$121,117,307175,9788333,604
Illinois139$95,692,507139,2137022,771
Virginia76$87,080,787126,6511,3954,169
North Carolina98$86,336,459125,5599533,322
Maryland97$86,067,622125,3489483,461
Ohio104$75,815,460112,2628412,724
Michigan113$71,214,288103,8006802,493
Massachusetts85$70,252,583101,8107873,372
New Jersey85$58,952,73385,6888822,374
Tennessee75$57,731,57384,3697942,798
Washington94$56,134,74681,9584712,377

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

Not listed: 9 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 2023.

Top metro areas

observed calculated calculated calculated calculated
New York-Newark-Jersey City, NY-NJ232$150,307,607218,314618
Chicago-Naperville-Elgin, IL-IN112$77,000,672112,037747
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD68$70,871,406103,0331,199
Los Angeles-Long Beach-Anaheim, CA107$65,430,01695,065569
Boston-Cambridge-Newton, MA-NH60$54,081,71778,354740
Washington-Arlington-Alexandria, DC-VA-MD-WV63$51,569,71374,972980
Houston-Pasadena-The Woodlands, TX56$49,509,39671,915959
Miami-Fort Lauderdale-West Palm Beach, FL65$43,689,97363,119534
Baltimore-Columbia-Towson, MD48$42,194,34361,588852
Dallas-Fort Worth-Arlington, TX48$34,171,78349,804720
Detroit-Warren-Dearborn, MI48$33,843,65449,265712
Tampa-St. Petersburg-Clearwater, FL46$31,290,74545,579556
Seattle-Tacoma-Bellevue, WA50$29,888,97543,624445
Minneapolis-St. Paul-Bloomington, MN-WI31$29,386,47242,5821,016
Raleigh-Cary, NC19$29,380,62642,6981,966

Source: CMS Medicare Physician & Other Practitioners public use files (Original Medicare Part B fee-for-service). The 68 areas with the most payment among those with at least 11 billers; non-metro parts of each state are one area. Data year 2023.

Specialties billing J0178 nationally

Ophthalmology accounts for 100% of payment for J0178 nationally in 2023, across 1 specialties on claims.

observed calculated calculated calculated calculated calculated
Ophthalmology3,18499%$2,347,241,354100%3,416,6201,073

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 2023.

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