CareCost Vials
1 × 0.5 mg
1 billing unit = 0.1 mg
0.5 mg dose → 5 billing units
J2778 · ranibizumab
0.5 mg or 0.3 mg, each its own single-dose vial or prefilled syringe · JZ on every dose, never JW
Calculate this patient's units ↓0.5 mg by intravitreal injection for wet AMD, once a month (approximately 28 days) · dose varies by indication, see the table below
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Patient owes, 0.5 mg
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37 payer price files · Commercial + Medicare · Copay and foundation status · Deductible, coinsurance and out-of-pocket math
Lucentis J2778 is billed per 0.1 mg: mg ÷ 0.1 mg/unit = billing units, with 1 billing unit equal to 0.1 mg. Two strengths cover the five labeled indications: 0.5 mg for wet AMD, RVO and myopic CNV, and 0.3 mg for diabetic macular edema and diabetic retinopathy. 0.5 mg is 5 units, 0.3 mg is 3 units. Each eye is billed as its own course of treatment, with its own laterality modifier and its own drug line.
Lucentis ships in two single-dose containers, one per strength: a 0.5 mg prefilled syringe or vial (0.05 mL of 10 mg/mL) and a 0.3 mg prefilled syringe or vial (0.05 mL of 6 mg/mL). Each dose draws its matching container with nothing left over, so every Lucentis claim bills JZ. Drawing a 0.3 mg dose from a 0.5 mg syringe would be off-label; there is no JW line for Lucentis.
Medicare pays $26.384 per 0.1 mg (ASP+6%), effective for claims in Q4 2026: $131.92
for the 0.5 mg (5-unit) drug line, plus $114.23 for 67028, for a one-eye allowed amount of $246.15.
Two strengths cover the five labeled indications: 0.5 mg for wet AMD, RVO and myopic CNV, and 0.3 mg for diabetic macular edema and diabetic retinopathy. Each strength draws its own single-dose syringe or vial with nothing left over, so every Lucentis claim bills JZ; there is no JW line. The injection is reported as 67028 per eye for every indication, with the eye modifier and, for a bilateral visit, modifier 50.
| Indication | Dose (mg) | Billing units | Container drawn | mg on JW | Procedure code |
|---|---|---|---|---|---|
| Neovascular (wet) AMD | 0.5 | 5 | 1 × 0.5 mg | 0 (JZ) | 67028 |
| Macular edema following RVO | 0.5 | 5 | 1 × 0.5 mg | 0 (JZ) | 67028 |
| Diabetic macular edema | 0.3 | 3 | 1 × 0.3 mg | 0 (JZ) | 67028 |
| Diabetic retinopathy | 0.3 | 3 | 1 × 0.3 mg | 0 (JZ) | 67028 |
| Myopic choroidal neovascularization | 0.5 | 5 | 1 × 0.5 mg | 0 (JZ) | 67028 |
Doses are the FDA label's recommended regimen for each indication (DailyMed de4e66cc, 2025 revision): wet AMD is 0.5 mg once a month (approximately 28 days), with less-effective less-frequent options after the first 3 or 4 monthly doses; RVO is 0.5 mg monthly; DME and diabetic retinopathy are 0.3 mg monthly; myopic CNV is 0.5 mg monthly for up to 3 months, retreated if needed. Treatment is open-ended for wet AMD, RVO, DME and DR; myopic CNV is the one indication with a labeled course.
Report 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). At a bilateral visit, the drug still goes on two separate lines, one per eye and each carrying its own JZ, rather than one line billed at double the units.
| Scenario | Drug line(s) | Injection line | Allowed | Patient owes (20%) |
|---|---|---|---|---|
| One eye, 0.5 mg (wet AMD, RVO, mCNV) | J2778 × 5 RT (or LT) JZ | 67028 RT (or LT) × 1 | $246.15 | $49.23 |
| Both eyes, 0.5 mg, same visit | J2778 × 5 RT JZ J2778 × 5 LT JZ | 67028-50 × 1 (150%) | $435.19 | $87.04 |
| One eye, 0.3 mg (DME, DR) | J2778 × 3 RT (or LT) JZ | 67028 RT (or LT) × 1 | $193.38 | $38.68 |
JZ: no discarded drug from the single-dose container. Every Lucentis claim bills JZ. JW: discarded drug, reported on its own claim line — there is no JW scenario for Lucentis, because the 0.5 mg and 0.3 mg doses each have their own matching single-dose syringe or vial. Drawing 0.3 mg from a 0.5 mg syringe and discarding the rest on a JW line is off-label; the label supplies the 0.3 mg strength instead.
J2778 × 5 JZ RT · 67028 RT × 1 for the intravitreal injection (LT if the
left eye is treated).
J2778 × 3 JZ RT · 67028 RT × 1 for the intravitreal injection.
Lucentis 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 Lucentis claim. 67028 already reports the injection. There is no separate guidance or imaging add-on code for 67028; the eye modifier itself (RT, LT, or 50) is what tells a one-eye claim apart from a bilateral one.
CMS's Medically Unlikely Edit for J2778 is 10 units per day — a bilateral wet AMD, RVO or myopic CNV visit (5 units per eye) lands exactly at that limit; the DME and diabetic retinopathy indications use 6 units for both eyes, well under it. A claim above the MUE is denied unless documentation supports an appeal.
Lucentis is supplied as two single-dose containers, one per strength: 0.5 mg (0.05 mL of 10 mg/mL solution, NDC 50242-080-03 prefilled syringe or 50242-080-88 vial) for wet AMD, RVO and myopic CNV, and 0.3 mg (0.05 mL of 6 mg/mL solution, NDC 50242-082-03 prefilled syringe or 50242-082-88 vial) for diabetic macular edema and diabetic retinopathy. Each carton is for single-eye use only. See the FDA Lucentis label (BLA 125156) for full dosing and administration instructions.
Lucentis (J2778, ranibizumab, Genentech) is the reference product for ranibizumab, with two marketed biosimilars billed under their own HCPCS codes at the same 0.1 mg unit: Byooviz (Q5124, ranibizumab-nuna, Biogen / Samsung Bioepis) and Cimerli (Q5128, ranibizumab-eqrn, Sandoz, whose US commercialization Sandoz paused in 2025, though claims still arrive under its code). Neither bills as J2778; a claim for Byooviz or Cimerli reports Q5124 or Q5128 with the same unit math. The other anti-VEGF products treating the same indications are Eylea (J0178, aflibercept, Regeneron), Eylea HD (J0177, aflibercept 8 mg, Regeneron), Pavblu (Q5147, aflibercept-ayyh, Amgen), Vabysmo (J2777, faricimab-svoa, Genentech), Beovu (J0179, brolucizumab-dbll, Novartis), and Avastin (J9035, bevacizumab, Genentech, used off-label and repackaged as the step-therapy agent most payers require first). See the HCPCS hub for coding across the full family. The Medicare rate for every quarter is on the cost page →
5 billing units. Lucentis J2778 bills 1 unit per 0.1 mg, so the 0.5 mg dose for wet AMD, RVO and myopic CNV is 5 units — 0.5 mg ÷ 0.1 mg/unit = 5 units, with no rounding.
Two separate drug lines, one per eye: J2778 × 5 RT JZ and J2778 × 5 LT JZ at the 0.5 mg dose, each its own JZ. Modifier 50 folds the injection into a single 67028-50 line, and Medicare pays that line at 150% of the fee schedule rather than pricing two.
JZ on every claim. Lucentis ships as two separate single-dose containers, 0.5 mg and 0.3 mg, each sized to the labeled dose for its indications, so the whole container is administered and nothing is left to discard. There is no JW scenario for Lucentis.
10 units per day for J2778 — two eyes at 5 units each for the 0.5 mg indications. A bilateral wet AMD visit lands exactly at that limit; the 0.3 mg indications use fewer units per eye.
Per 0.1 mg. J2778's billing unit is 0.1 mg, not a full mg and not 1 container — the 0.5 mg syringe happens to equal 5 units and the 0.3 mg syringe 3 units, but the claim reports mg-based units, not container count.
0.3 mg per eye, which is 3 billing units — its own single-dose syringe or vial, separate from the 0.5 mg strength used for wet AMD, RVO and myopic CNV. The injection still reports as 67028 per eye, and the claim bills JZ.
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 (Lucentis label, Genentech, BLA125156); CMS single-dose container JW/JZ policy (effective July 1, 2023); CPT codebook administration-code guidance; the CareCost Clearance coverage corpus (27 payers, 396 rules) for ranibizumab.
Reviewed September 20, 2026 by Erin Rose, CareCost Estimate founder. Methodology →