HCPCS Level II J0177: Injection, aflibercept hd, 1 mg
Commercial payers pay $343 on average nationally for this procedure.
HCPCS Level II code J0177 represents an injection of aflibercept hd, 1 mg, used as an intravitreal pharmacologic therapy for retinal vascular conditions; the service is an intravitreal injection typically performed in an ophthalmology clinic or ambulatory surgical center and billed as the drug administration for a 1 mg dose of aflibercept.
For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only).
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National Reimbursement Benchmarks
National commercial rates for J0177 cluster around the BUCA average of $343.10, with most large payers showing medians near $311–$324. Blue Cross Blue Shield and Cigna exhibit relatively tight interquartile spreads: BCBS P75–P25 = $362.30 - $312.00 = $50.30 and Cigna P75–P25 = $318.00 - $311.40 = $6.60, indicating consistent middle-range reimbursement. UnitedHealth Group and Aetna display wider dispersion: UnitedHealth Group P75–P25 = $333.10 - $311.40 = $21.70 and Aetna P75–P25 = $323.00 - $82.90 = $240.10, with Aetna showing the largest spread by far.
Payer-specific maxima and minima also vary: Aetna reaches a high of $3,424.00 and a low of $31.50, while UnitedHealth Group and Cigna have maximums of $650.50 and $415.60 respectively. Blue Cross Blue Shield’s rates are concentrated near its median of $335.60, reinforcing its narrow IQR. Overall, BUCA’s mean sits centrally among payer means, reflecting an average commercial position for this code.