CareCost Vials
1 × 2 mg
1 billing unit = 1 mg
2 mg dose → 2 billing units
J0178 · aflibercept
2 mg single-dose vial or prefilled syringe · JZ on every adult dose, JW only for the pediatric ROP dose
Calculate this patient's units ↓2 mg by intravitreal injection for wet AMD, every 4 weeks for the first 3 months then every 8 weeks · dose varies by indication, see the table below
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Patient owes, 2 mg
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37 payer price files · Commercial + Medicare · Copay and foundation status · Deductible, coinsurance and out-of-pocket math
Eylea J0178 is billed per 1 mg: mg ÷ 1 mg/unit = billing units, with 1 billing unit equal to 1 mg. The adult dose is a flat 2 mg per eye for every labeled indication except retinopathy of prematurity, a pediatric 0.4 mg dose. 2 mg is 2 units, 0.4 mg rounds up to 1 unit. Two eyes are two separate treatment courses, each with its own laterality and its own drug line.
Eylea ships in a single 2 mg (0.05 mL of 40 mg/mL) single-dose vial or single-dose pre-filled syringe, one container size for every indication. The standard 2 mg adult dose draws exactly one vial with nothing left over, so it bills JZ; only the 0.4 mg ROP dose, drawn from the same vial, leaves drug to discard on a JW line (arithmetic below).
Medicare pays $722.251 per 1 mg (ASP+6%), effective for claims in Q4 2026: $1,444.50
for the 2 mg drug line, plus $114.23 for 67028, for a one-eye allowed amount of $1,558.73.
Every adult indication is dosed at 2 mg per eye, which draws one 2 mg vial with nothing left over: bill JZ. Retinopathy of prematurity is a 0.4 mg pediatric dose drawn from the same 2 mg vial, leaving 1.6 mg to discard on a JW line. The injection is reported as 67028 per eye for every indication. The procedure code does not vary with diagnosis, only the eye modifier and, for a bilateral visit, modifier 50 do.
| Indication | Dose (mg) | Billing units | Vial drawn | mg on JW | Procedure code |
|---|---|---|---|---|---|
| Neovascular (wet) AMD | 2 | 2 | 1 × 2 mg | 0 (JZ) | 67028 |
| Macular edema following RVO | 2 | 2 | 1 × 2 mg | 0 (JZ) | 67028 |
| Diabetic macular edema | 2 | 2 | 1 × 2 mg | 0 (JZ) | 67028 |
| Diabetic retinopathy | 2 | 2 | 1 × 2 mg | 0 (JZ) | 67028 |
| Retinopathy of prematurity (pediatric) | 0.4 | 1 | 1 × 2 mg | 1.6 (JW) | 67028 |
Doses are the FDA label's recommended regimen for each indication (DailyMed f96cfd69, 2026): AMD is 2 mg every 4 weeks for the first 3 months then every 8 weeks; RVO is 2 mg every 4 weeks; DME and diabetic retinopathy are 2 mg every 4 weeks for the first 5 doses then every 8 weeks; ROP is 0.4 mg per eye, repeated no sooner than 10 days later if needed. Treatment is open-ended: the label sets no stopping point, and the maintenance interval is individualized on OCT and visual acuity.
Eylea is billed per eye: RT or LT on both the drug line and the injection line for a single eye, or modifier 50 once on the injection line when both eyes are treated at the same visit, which Medicare allows at 150% of the fee schedule ($114.23 → $171.35). A bilateral visit is two separate drug lines — one per eye, each its own JZ — never a single doubled line.
| Scenario | Drug line(s) | Injection line | Allowed | Patient owes (20%) |
|---|---|---|---|---|
| One eye | J0178 × 2 RT (or LT) JZ | 67028 RT (or LT) × 1 | $1,558.73 | $311.75 |
| Both eyes, same visit | J0178 × 2 RT JZ J0178 × 2 LT JZ | 67028-50 × 1 (150%) | $3,060.35 | $612.07 |
JZ: no discarded drug from the single-dose vial. JW: discarded drug, reported on its own claim line. One of the two is required on every J0178 claim per CMS's July 1, 2023 single-dose container policy.
J0178 × 2 JZ RT · 67028 RT × 1 for the intravitreal injection (LT if the
left eye is treated).
J0178 × 1 · J0178 × 1 JW · 67028 × 1 for the injection.
Eylea has no administration code of its own; the injection is the procedure, 67028 (intravitreal injection of a pharmacologic agent), reported per eye: RT or LT on the line, or once with modifier 50 when both eyes are injected at the same visit, allowed at 150% of the fee schedule. 96372, the general therapeutic injection code, is wrong on every Eylea claim. 67028 already reports the injection. 67028 has no guidance or imaging add-on code; the modifier alone (RT, LT, or 50) is what distinguishes a one-eye claim from a bilateral one.
CMS's Medically Unlikely Edit for J0178 is 4 units per day — the two-eye adult dose (2 units per eye) lands exactly at that limit; a claim above it is denied unless documentation supports an appeal.
Eylea is supplied as a single 2 mg (0.05 mL of a 40 mg/mL solution) single-dose vial or single-dose pre-filled syringe, one container size for every indication, including the 0.4 mg pediatric ROP dose, which is drawn from the same 2 mg vial. NDC 61755-005-02 (vial kit) and 61755-005-55 (pre-filled syringe). See the FDA Eylea label (BLA 125387) for full dosing and administration instructions.
Eylea (J0178, aflibercept, Regeneron) is one of nine anti-VEGF products routinely billed for retinal disease: Eylea HD (J0177, aflibercept 8 mg, Regeneron), Pavblu (Q5147, aflibercept-ayyh, Amgen, the aflibercept biosimilar), Vabysmo (J2777, faricimab-svoa, Genentech), Lucentis (J2778, ranibizumab, Genentech), Cimerli (Q5128, ranibizumab-eqrn, Sandoz), Byooviz (Q5124, ranibizumab-nuna, Biogen / Samsung Bioepis), Beovu (J0179, brolucizumab-dbll, Novartis), and Avastin (J9035, bevacizumab, Genentech, used off-label and repackaged as the step-therapy agent most payers require first). Eylea HD carries its own HCPCS code and is not interchangeable with Eylea on the claim; Pavblu, the aflibercept biosimilar, bills under its own code too (Q5147). See the HCPCS hub for coding across the full family. The Medicare rate for every quarter is on the cost page →
2 billing units. Eylea J0178 bills 1 unit per 1 mg, so the standard 2 mg adult dose is 2 units — 2 mg ÷ 1 mg/unit = 2 units, with no rounding.
Two separate drug lines, one per eye: J0178 × 2 RT JZ and J0178 × 2 LT JZ, each its own dose and its own JZ. The injection reports once with modifier 50 — 67028-50 × 1 — which Medicare allows at 150% of the fee schedule.
JZ on nearly every claim. The 2 mg adult dose draws exactly one 2 mg vial with nothing left over, so it bills JZ. JW only applies to the pediatric ROP dose, where 0.4 mg is drawn from the same 2 mg vial and 1.6 mg is discarded.
4 units per day for J0178 — two eyes at 2 units each. A bilateral visit at the standard adult dose lands exactly at that limit.
Per mg. J0178's billing unit is 1 mg, not 1 vial — the 2 mg vial happens to equal 2 units at the standard adult dose, but the claim reports mg-based units, not container count.
0.4 mg per eye, which rounds up to 1 billing unit. The dose is drawn from the same 2 mg single-dose vial as the adult dose, discarding 1.6 mg on a JW line, and the injection reports as 67028 per eye.
Data current: pricing Q4 2026 · payer policies Aug 2026
Sources: CMS ASP pricing files (Q4 2026); Medicare physician fee schedule (67028, national non-facility); FDA-approved prescribing information (Eylea label, Regeneron, BLA125387); CMS single-dose container JW/JZ policy (effective July 1, 2023); CPT codebook administration-code guidance; the CareCost Clearance coverage corpus (28 payers, 388 rules) for aflibercept.
Reviewed September 20, 2026 by Erin Rose, CareCost Estimate founder. Methodology →