HCPCS code J2778: Ranibizumab injection, per 0.1 mg2026 Medicare rate & RVUs in Texas
Ranibizumab is an intravitreal anti-VEGF drug reported in 0.1 mg units for retinal conditions such as neovascular AMD and diabetic macular edema.
CMS doesn’t publish an office rate for J2778 in Texas.
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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On this page 9 sections
What J2778 covers
Ranibizumab is an anti-VEGF medicine injected into the vitreous of the eye to treat retinal disease. Ophthalmologists, often retina specialists, administer it in outpatient eye-care settings for conditions including neovascular age-related macular degeneration, macular edema after retinal vein occlusion, diabetic macular edema, and diabetic retinopathy. The drug is reported separately from the service of injecting it.
J2778 represents each 0.1 mg of ranibizumab; for example, a 0.5 mg dose equals five units. The CMS physician fee schedule status is E, meaning the drug is excluded from that fee schedule. When Medicare covers it, payment generally follows the Part B drug method using CMS quarterly Average Sales Price drug pricing files. Coverage is left to the Medicare contractor’s judgment.
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 J2778 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | Unavailable |
| Beaumont, TX | Unavailable | Unavailable |
| Brazoria, TX | Unavailable | Unavailable |
| Dallas, TX | Unavailable | Unavailable |
| Fort Worth, TX | Unavailable | Unavailable |
| Galveston, TX | Unavailable | Unavailable |
| Houston, TX | Unavailable | Unavailable |
| Rest of Texas | Unavailable | Unavailable |
How the J2778 rate is calculated
Each of J2778’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 · J2778
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 J2778
J2778 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 · J2778
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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J2778 isn’t priced in this setting.
J2778 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 67028Intravitreal injectionMedication delivered into vitreous cavity
- 67028 reports the procedure of injecting a pharmacologic agent into the vitreous. J2778 reports the ranibizumab drug quantity.
- J2777Faricimab injectionPer 0.1 mg
- J2777 is for faricimab-svoa; J2778 is for ranibizumab. Select the code for the drug administered.
- J2779Susvimo ranibizumabPer 0.1 mg
- J2779 identifies ranibizumab associated with the Susvimo delivery system. J2778 reports ranibizumab in 0.1 mg units.
J2778 billing questions
What does one J2778 unit represent?
One unit represents 0.1 mg of ranibizumab. A 0.5 mg dose equals five units.
Does J2778 include the intravitreal injection?
No. J2778 identifies the ranibizumab drug quantity; CPT 67028 identifies the intravitreal injection service. They are commonly reported for the same encounter.
How does Medicare treat J2778?
CMS assigns status E, excluding J2778 from the physician fee schedule. When covered, Medicare generally pays it as a Part B drug through the quarterly ASP pricing method, with coverage left to the Medicare contractor’s judgment.
How is J2778 different from J2777?
J2778 reports ranibizumab, while J2777 reports faricimab-svoa. Both are intravitreal retinal drugs, but the code follows the specific drug administered.
When would J2779 be used instead?
J2779 identifies ranibizumab associated with the Susvimo delivery system. J2778 is the code for ranibizumab reported by 0.1 mg for injection.
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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