HCPCS code J0177: Aflibercept HD, per 1 mg2026 Medicare rate & RVUs

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What J0177 covers

Aflibercept HD is an intravitreal medicine used by ophthalmologists, commonly retina specialists, to treat retinal conditions such as neovascular age-related macular degeneration, diabetic macular edema, diabetic retinopathy, and macular edema after retinal vein occlusion. The drug is injected into the vitreous of the eye during an ophthalmic visit or procedure. This code identifies the high-dose formulation, rather than standard-dose aflibercept or the injection procedure itself.

CMS assigns this code physician fee schedule status E, excluding it from the physician fee schedule; when Medicare covers it, payment is under another method. It is classified as a Part B drug, for which Medicare generally uses CMS quarterly Average Sales Price drug pricing files when covered. Coverage is left to the Medicare contractor's judgment. Each billing unit represents 1 mg of aflibercept HD, so an 8 mg administered dose is reported as 8 units. The intravitreal administration is identified separately by its procedure code when applicable.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where J0177 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

J0177 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the J0177 rate is calculated

Each of J0177’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for J0177

J0177 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

J0177 compared with similar codes

How to choose

J0178Aflibercept injectionPer 1 mg

Use J0177 for high-dose aflibercept and J0178 for standard-dose aflibercept. The code must match the formulation administered.

67028Intravitreal injectionMedication delivered into vitreous cavity

J0177 identifies the aflibercept HD drug dose; 67028 identifies the intravitreal injection procedure.

J0179BrolucizumabPer 1 mg

J0179 identifies brolucizumab, a different intravitreal drug. J0177 applies when high-dose aflibercept is administered.

Codes related to J0177

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates