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    v1.0.28
    OpenPayerBilling CodesDrugs Administered Other than Oral MethodHCPCS hcpcs-j2777-faricimab-intravitreal-injection-0-1-mg
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    HCPCS Level II J2777: Injection, faricimab-svoa 0.1 mg

    Commercial payers pay $111 on average nationally for this procedure.

    HCPCS Level II code J2777 describes the drug product faricimab-svoa, 0.1 mg supplied for intravitreal injection; the service is the administration of an ophthalmic anti-VEGF biologic for retinal vascular conditions and the typical site of service is an outpatient ophthalmology setting such as an ambulatory surgery center or clinic for intravitreal injections.

    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

    BUCA (average commercial) sits at a mean of $110.80 for J2777, positioning it above most individual commercial carriers on a mean basis. Blue Cross Blue Shield (BCBS) and Cigna have similar central tendencies near the mid-$30s, while Aetna and UnitedHealth Group display higher mean variability driven by upper outliers; Aetna’s mean is $481.10 but that is heavily influenced by a $4,560 maximum, and UnitedHealth Group’s mean is $38.30 with a narrower ceiling relative to Aetna.

    Dispersion (P75 minus P25) highlights differences in rate tightness: Blue Cross Blue Shield’s interquartile spread is $4.0 (from $34.7 to $39.1), and Cigna’s spread is $1.5 (from $33.9 to $35.4), making Cigna the tightest and Aetna the widest with an interquartile spread of $25.0 (from $16.9 to $41.8). UnitedHealth Group’s spread is $3.4 and BUCA’s spread is $5.1, indicating modest variability for those payers relative to Aetna’s wide dispersion.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Clinical & Coding Specifications

    Clinical Context

    A 72-year-old patient presents to a retina specialist clinic with decreased central vision and metamorphopsia in the right eye following a diagnosis of central retinal vein occlusion. Optical coherence tomography confirms center-involving macular edema. The retina specialist documents visual acuity, intraocular pressure, consent for intravitreal therapy, and discusses risks of injection. The patient receives an intravitreal administration of faricimab-svoa (billed with J2777) in the clinic procedure room. The procedure workflow includes ocular antisepsis, topical anesthesia, a sterile eyelid speculum, pre- and post-injection medications as indicated, and monitoring for immediate complications. The corresponding CPT procedure for the intravitreal injection is 67028. Post-procedure instructions and a follow-up OCT appointment are scheduled to assess treatment response and plan subsequent injections per therapeutic protocol.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    67028Intravitreal injection of a pharmacologic agentPrimary procedure code used to report the intravitreal administration (clinical service) when billing for the injection of faricimab-svoa billed with J2777.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207WX0107XRetina Specialist (Ophthalmology) PhysicianAn ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases.
    3245S0500XChildren's Substance Abuse Rehabilitation FacilityA facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the tre…
    341800000XMilitary/U.S. Coast Guard TransportTransportation Services · Military/U.S. Coast Guard Transport
    2083C0008XClinical Informatics PhysicianPhysicians who practice Clinical Informatics collaborate with other health care and information technology professionals to analyze, design, implement…
    261QS1200XSleep Disorder Diagnostic Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    261QF0050XNon-Surgical Family Planning Clinic/CenterAn entity, facility, or distinct part of a facility, or mobile unit providing non-surgical, family planning/reproductive services including physical e…
    207ZP0105XClinical Pathology/Laboratory Medicine PhysicianA pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the labora…
    1223D0001XPublic Health DentistryThe science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of…

    Related ICD-10-CM Codes

    17 rows

    ICD-10-CM CodeDescription
    H34.8110Central retinal vein occlusion, right eye, with macular edema
    H34.8111Central retinal vein occlusion, right eye, with retinal neovascularization
    H34.8112Central retinal vein occlusion, right eye, stable
    H34.8120Central retinal vein occlusion, left eye, with macular edema
    H34.8121Central retinal vein occlusion, left eye, with retinal neovascularization
    H34.8122Central retinal vein occlusion, left eye, stable
    H34.8130Central retinal vein occlusion, bilateral, with macular edema
    H34.8131Central retinal vein occlusion, bilateral, with retinal neovascularization
    H34.8132Central retinal vein occlusion, bilateral, stable
    H34.8310Tributary (branch) retinal vein occlusion, right eye, with macular edema

    Showing 1–10 of 17

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    10 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Chimeric Antigen Receptor (CAR) T-Cell TherapyColorado Rocky Mountain Health Plans2026-08-01
    Allogeneic Hematopoietic Progenitor Cell TherapyAmbetter Georgia2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Idaho Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for New Jersey Only)UnitedHealthcare2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Ohio Only)UnitedHealthcare2026-08-01
    Reblozyl (luspatercept-aamt) Medical Benefit Drug PolicyUnitedHealthcare2026-08-01

    Related Codes

    HCPCS-J0013-ESKETAMINE-NASAL-SPRAY-1MG

    HCPCS Level II J0013: Esketamine Nasal Spray, 1 mg

    HCPCS-J0120-INJECTION-TETRACYCLINE-250MG

    HCPCS Level II J0120: Injection, Tetracycline, up to 250 mg

    HCPCS-J0121-OMADACYCLINE-INJECTION-1MG

    HCPCS Level II J0121: Omadacycline Injection, 1 mg

    HCPCS-J0122-ERAVACYCLINE-INJECTION-1MG

    HCPCS Level II J0122: Injection, eravacycline, 1 mg

    HCPCS-J0129-ABATACEPT-INJECTION-10MG-PHYSICIAN-SUPERVISED

    HCPCS Level II J0129: Abatacept Injection, 10 mg

    HCPCS-J0130-INJECTION-ABCIXIMAB-10MG

    HCPCS Level II J0130: Injection abciximab, 10 mg

    HCPCS-J0131-INJECTION-ACETAMINOPHEN-10MG-PARENTERAL-ANALGESIC

    HCPCS Level II J0131: Injection, Acetaminophen 10 mg

    HCPCS-J0132-INJECTION-ACETYLCYSTEINE-100MG-INJECTABLE-MEDICATION

    HCPCS Level II J0132: Injection, Acetylcysteine 100 mg

    HCPCS-J0133-ACYCLOVIR-INJECTION-5MG

    HCPCS Level II J0133: Injection, Acyclovir 5 mg

    HCPCS-J0134-ACETAMINOPHEN-INJECTION-FRESENIUS-KABI-10MG

    HCPCS Level II J0134: Injection, Acetaminophen (10 mg)

    Showing 1–10 of 991

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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