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.
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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.