CareCost Vials
1 × 6 mg
1 billing unit = 0.1 mg
6 mg dose → 60 billing units
J2777 · faricimab-svoa
6 mg single-dose vial or prefilled syringe, one per eye · always JZ · a claim billed at 6 units instead of 60 (the vial-count error) pays a tenth of the drug: $187.93 instead of $1,879.32
Calculate this patient's units ↓6 mg by intravitreal injection per eye, every 4 weeks for the first 4 doses then every 8 to 16 weeks for wet AMD · the same 6 mg dose is used for every indication, see the laterality table below
This Vabysmo claim carries straight into Claim Check.
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Patient owes, 6 mg
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36 payer price files · Commercial + Medicare · Copay and foundation status · Deductible, coinsurance and out-of-pocket math
Vabysmo J2777 is billed per 0.1 mg: total mg administered ÷ 0.1 = billing units. The labeled dose is the same 6 mg per eye across all three indications (wet AMD, diabetic macular edema and macular edema following retinal vein occlusion), so the billing-units math never changes by diagnosis; only the interval between doses does.
A 6 mg dose is 60 billing units, not 6. Reading the unit count as though it matched the milligram count, billing 6 units instead of 60, is the standard under-billing error on this code, and it draws payment for one-tenth of the drug: $187.93 rather than $1,879.32 at the current ASP rate.
Vabysmo ships in one container size, a 6 mg single-dose vial or a 6 mg single-dose prefilled syringe, both 0.05 mL of 120 mg/mL solution. The 6 mg dose exactly fills the container, so nothing is left to discard: every claim bills modifier JZ, never JW.
Medicare pays $31.322 per 0.1 mg unit (ASP+6%), effective for claims in Q4 2026:
$1,879.32 for the 60-unit, 6 mg dose above. Add 67028 at $114.23 non-facility and the allowed amount for
one eye is $1,993.55; the patient's 20% share is $398.71 after the Part B deductible is met.
Each eye is its own treatment course, with its own 6 mg dose, its own vial or syringe, and its own line on the claim. One eye reported alone carries RT or LT beside JZ on the drug line. Both eyes injected at the same visit are two full 60-unit drug lines (one RT, one LT), plus a single 67028 line billed with modifier 50, which Medicare pays at 150% of the single-eye rate.
| Scenario | Drug line(s) | Units | Administration | Allowed amount |
|---|---|---|---|---|
| One eye | J2777 × 60 RT JZ (or LT) | 60 | 67028 × 1, RT or LT | $1,993.55 |
| Both eyes, one visit | J2777 × 60 RT JZ · J2777 × 60 LT JZ | 60 + 60 | 67028-50 × 1 (150%) | $3,929.99 |
Vabysmo bills modifier JZ on every claim. The 6 mg dose is drawn from a 6 mg single-dose vial or prefilled syringe, the container's only size, so the dose and the container match exactly and nothing is left to discard. CMS's single-dose container policy still requires one of JW or JZ on every unit-dosed line; for Vabysmo, that line is always JZ.
J2777 × 60 JZ · 67028 × 1 per eye treated.
J2777 × 60 RT JZ · J2777 × 60 LT JZ · 67028-50 × 1.
Vabysmo has no administration code of its own: the injection is the procedure, and 67028 (intravitreal injection of a pharmacologic agent) reports it, once per eye. Report RT or LT on the line, or bill 67028 once with modifier 50 when both eyes are injected at the same visit; Medicare's bilateral indicator pays that combined line at 150% of the single-eye fee. 96372, the general therapeutic injection code, is wrong on every Vabysmo claim: 67028 already reports the injection, and no guidance add-on code exists for it.
CMS's Medically Unlikely Edit for J2777 is 120 units per day, exactly two eyes' worth of the 6 mg dose (60 units each). A visit that treats both eyes lands right at that limit, not under it, so a same-day claim above 120 units is denied unless documentation supports an appeal.
Vabysmo is supplied in one container size: a 6 mg (0.05 mL of 120 mg/mL solution) single-dose glass vial, NDC 50242-096-01, or a 6 mg single-dose prefilled syringe, NDC 50242-096-77. Both forms draw the identical 6 mg dose, so there is no vial-mixing decision to make: one container is one dose, one eye. See the FDA Vabysmo label (BLA761235) for full dosing and administration instructions.
Vabysmo (J2777, faricimab-svoa, Genentech) is one of nine anti-VEGF and Ang-2 intravitreal products billed to payers for wet AMD, diabetic macular edema and macular edema after retinal vein occlusion: Eylea (J0178, aflibercept, Regeneron), Eylea HD (J0177, aflibercept 8 mg, Regeneron), Pavblu (Q5147, aflibercept-ayyh, Amgen), Lucentis (J2778, ranibizumab, Genentech), Cimerli (Q5128, ranibizumab-eqrn, Sandoz), Byooviz (Q5124, ranibizumab-nuna, Biogen/Samsung Bioepis), Beovu (J0179, brolucizumab-dbll, Novartis) and repackaged Avastin (J9035, bevacizumab, off-label). Each product bills its own code and its own unit size: Vabysmo's 0.1 mg unit is not the aflibercept or ranibizumab unit, and a dose is never converted from one to another. See the HCPCS hub for coding across the full family. The Medicare rate for every quarter is on the cost page →
60 billing units. J2777 bills 1 unit per 0.1 mg, so a 6 mg dose (0.05 mL of 120 mg/mL) is 6 ÷ 0.1 = 60 units.
CMS assigns J2777 a billing unit of 0.1 mg. Billing 6 units for a 6 mg dose, reading the unit as if it were 1 mg, is the classic under-billing error on this code; it draws payment for one-tenth of the drug.
Two drug lines, one per eye: J2777 × 60 units RT JZ and J2777 × 60 units LT JZ, plus 67028-50 for the injection at 150% of the single-eye fee. Each eye is its own dose and its own line.
JZ, on every claim. The 6 mg dose matches the 6 mg single-dose vial or prefilled syringe exactly, so nothing is left over to report as waste on a JW line.
120 units per day for J2777, exactly two eyes' worth of the 6 mg dose (60 units each). A bilateral visit lands right at the limit, not under it.
67028, once per eye. 67028 is intravitreal injection of a pharmacologic agent; it is billed RT or LT, or once with modifier 50 when both eyes are injected at the same visit. 96372 is not correct for an intravitreal injection.
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 (Vabysmo label, Genentech, BLA761235); CMS single-dose container JW/JZ policy (effective July 1, 2023); CPT codebook administration-code guidance; the CareCost Clearance coverage corpus (27 payers, 201 rules) for faricimab.
Reviewed September 20, 2026 by Erin Rose, CareCost Estimate founder. Methodology →