HCPCS J0177: what Medicare pays in 2026
Drug CMS description: Inj, aflibercept hd, 1 mg
Medicare's Part B payment limit for J0177 from October 1 to December 31, 2026 is $290.902 per billing unit of 1 MG. Check the number of units on your bill: drug lines are billed in these units.
Medicare amounts for J0177 in 2026
- Hospital outpatient rate, national (APC 0704)
- $298.68
- Hospital outpatient status G
- pass-through drug
- Part B drug payment limit per 1 MG
- $290.902
Hospital outpatient rates are national figures before Medicare's wage adjustment, which moves about 60% of the rate up or down with local hospital wages.
What providers charged Medicare for J0177 in 2024
From CMS's national utilization file (the most recent full year published). The charge is the provider's list price, the same kind of figure an uninsured patient is usually billed.
| Setting | Units billed | Average charge | Medicare allowed | Charge vs allowed |
|---|---|---|---|---|
| In an office or other non-facility setting | 1,945,486 | $712.22 | $329.18 | 2.2× |
| In a facility setting | 2,620 | $479.49 | $330.81 | 1.4× |