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HCPCS code J0179: Brolucizumab, per 1 mg2026 Medicare rate & RVUs

Brolucizumab is an intravitreal anti-VEGF drug reported for treatment of neovascular age-related macular degeneration or diabetic macular edema.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J0179

Brolucizumab, per 1 mg

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for J0179 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What J0179 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What J0179 covers

Brolucizumab is an anti-VEGF medicine administered by injection into the vitreous of the eye for retinal disease, including neovascular age-related macular degeneration and diabetic macular edema. Ophthalmologists, often retina specialists, report J0179 for the medication furnished for an intravitreal treatment. J0179 identifies the drug quantity, while CPT 67028 identifies the intravitreal injection procedure when separately reportable.

Each J0179 unit represents 1 mg of brolucizumab, so a 6 mg amount corresponds to 6 units. CMS excludes this code from the physician fee schedule under status E. When Medicare covers the drug, it generally pays as a Part B drug using CMS’s quarterly Average Sales Price drug pricing files. Coverage is determined by the Medicare contractor.

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 J0179 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

J0179 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

J0179 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
J0179 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the J0179 rate is calculated

Each of J0179’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 · J0179

RVUs × geographic indexes × conversion factor

Office or facility?

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 J0179

J0179 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 · J0179

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

J0179 isn’t priced in this setting.

J0179 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • J0179

    Brolucizumab, per 1 mg0 wRVU

    Not priced

  • J0178

    Aflibercept injection, per 1 mg0 wRVU

    Not priced

  • J0177

    Aflibercept HD, per 1 mg0 wRVU

    Not priced

  • J2777

    Faricimab injection, per 0.1 mg0 wRVU

    Not priced

  • 67028

    Intravitreal injection, medication delivered into vitreous cavity1.4 wRVU

    $114.23

How to choose

J0178Aflibercept injectionPer 1 mg
J0178 reports aflibercept, while J0179 reports brolucizumab. Select the code for the drug administered.
J0177Aflibercept HDPer 1 mg
J0177 reports high-dose aflibercept; J0179 reports brolucizumab. These are different drugs, not different strengths of the same drug.
J2777Faricimab injectionPer 0.1 mg
J2777 reports faricimab, while J0179 reports brolucizumab. Use the code matching the medication administered.
67028Intravitreal injectionMedication delivered into vitreous cavity
CPT 67028 describes the intravitreal injection procedure; J0179 identifies the brolucizumab drug in 1 mg units.

Codes related to J0179

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

Codes related to J0179
CodeHow it relatesNational office range
Often billed with
67028Intravitreal injection, medication delivered into vitreous cavityDescribes the intravitreal injection procedure used to administer the drug.$103.45–$145.87
Used instead
J0178Aflibercept injection, per 1 mgAflibercept is another intravitreal anti-VEGF treatment option.No office rate
J0177Aflibercept HD, per 1 mgHigh-dose aflibercept is another intravitreal anti-VEGF treatment option.No office rate
J2777Faricimab injection, per 0.1 mgFaricimab is another intravitreal treatment option for retinal disease.No office rate
J2778Ranibizumab injection, per 0.1 mgRanibizumab is another intravitreal anti-VEGF treatment option.No office rate

J0179 billing questions

How many units represent a 6 mg dose?

Report 6 units because each unit represents 1 mg of brolucizumab.

What conditions is brolucizumab used to treat?

It is used for neovascular age-related macular degeneration and diabetic macular edema.

Is the intravitreal injection procedure included in J0179?

J0179 represents the drug, not the injection procedure. CPT 67028 describes the intravitreal injection procedure when separately reportable.

How does Medicare treat J0179?

CMS excludes J0179 from the physician fee schedule under status E. When covered, Medicare generally pays it as a Part B drug using quarterly ASP pricing files; the Medicare contractor determines coverage.

How is J0179 different from J0178?

J0179 represents brolucizumab in 1 mg units. J0178 represents aflibercept and is a different anti-VEGF drug.

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

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