HCPCS code J0177: Aflibercept HD, per 1 mg2026 Medicare rate & RVUs in Missouri
Reports high-dose aflibercept given by intravitreal injection for retinal disease, with each unit representing 1 mg of the drug administered.
CMS doesn’t publish an office rate for J0177 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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.
How the rate is built · J0177
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
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.
Place of service · J0177
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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J0177 isn’t priced in this setting.
J0177 compared with similar codes
Compare codes · National
4 codes, side by side
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.
J0177 billing questions
How many units represent an 8 mg dose?
Each unit represents 1 mg, so an 8 mg administered dose corresponds to 8 units.
How does J0177 differ from J0178?
J0177 identifies high-dose aflibercept. J0178 identifies standard aflibercept; select the code matching the formulation administered.
Does J0177 include the intravitreal injection procedure?
No. J0177 identifies the drug, while 67028 identifies intravitreal injection administration; report the procedure when performed and applicable.
How does Medicare treat J0177?
CMS excludes it from the physician fee schedule under status E. When covered, it is paid under another payment method; as a Part B drug, it generally uses CMS quarterly ASP drug pricing files, and coverage is left to the Medicare contractor.
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
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