How much does Medicare pay for HCPCS J2782?

Medicare allowed an average of $108.28 per service and paid $86.27 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $221.06, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is HCPCS code J2782?

Injection, avacincaptad pegol, 0.1 mg. It was billed 1,429,067 times to 15,948 Medicare beneficiaries by 568 providers in 2024.

Does J2782 pay differently in an office than a hospital?

Yes. The allowed amount averaged $108.28 in an office setting and $108.49 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills J2782 most?

Ophthalmology, with 1,428,267 services from 567 clinicians. Next are Ambulatory Surgical Center.

HCPCS J2782

Injection, avacincaptad pegol, 0.1 mg

$108.28Medicare-allowed amount per service, averaged across 1,429,067 services

Providers submitted

$221.06

Asking price, not received

Medicare allowed

$108.28

The fee schedule figure

Medicare paid

$86.27

Balance is patient coinsurance

Providers submitted an average of $221.06 for this code and Medicare allowed $108.28 — 2.0× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $86.27 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $108.28
Hospital / facility: $108.49

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 1,428,267 services were billed in an office setting and 800 in a facility.

Services: 1,429,067
Beneficiaries: 15,948
Providers billing it: 568
Total allowed: $154,739,375

What Medicare pays for HCPCS J2782

Across 1,429,067 services billed by 568 providers to 15,948 beneficiaries, Medicare allowed an average of $108.28 per service. That is 89.6 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

This is a drug or supply code rather than a service. The unit is usually a dose or a milligram, so the per-service figure is small by construction and the total is what carries meaning — read it alongside the service count rather than on its own.

Who bills J2782

Specialty	Services	Beneficiaries	Avg allowed	Providers
Ophthalmology	1,428,267	15,937	$108.28	567
Ambulatory Surgical Center	800	11	$108.49	1

J2782 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	264,802	$108.35	$86.46	68
Florida	215,685	$108.57	$86.51	73
California	84,163	$108.10	$86.48	43
Virginia	81,939	$108.09	$86.45	28
North Carolina	54,940	$108.39	$86.44	21
Arizona	54,801	$108.39	$86.56	21
Ohio	50,482	$108.53	$86.55	22
New York	49,524	$108.47	$86.54	26
Colorado	43,581	$108.30	$86.27	19
Illinois	40,960	$108.27	$86.46	21
Tennessee	39,665	$108.30	$86.51	19
Pennsylvania	38,663	$108.43	$86.39	20
Georgia	35,540	$108.50	$86.46	21
New Jersey	30,520	$108.51	$86.53	14
Maryland	25,922	$108.45	$86.50	14
Massachusetts	25,750	$108.47	$86.59	9
Indiana	23,788	$108.31	$86.37	11
Utah	23,500	$108.11	$86.34	9
South Carolina	22,500	$108.43	$86.39	6
Kentucky	20,321	$108.32	$86.39	11
Michigan	19,980	$108.06	$86.48	10
Oregon	17,977	$107.53	$86.21	9
Kansas	17,736	$108.62	$86.49	9
Arkansas	15,920	$108.41	$86.47	8
Nevada	15,000	$100.80	$80.31	4
South Dakota	13,880	$108.56	$86.50	2
Connecticut	13,120	$108.33	$86.48	5
Missouri	12,981	$108.32	$86.44	7
Nebraska	12,640	$107.54	$86.59	3
Louisiana	10,221	$108.61	$86.53	3
Alabama	9,720	$107.84	$86.33	4
Idaho	9,360	$108.58	$86.51	2
Oklahoma	6,920	$108.46	$86.42	5
Wisconsin	5,462	$108.35	$86.32	4
Iowa	5,142	$108.45	$86.40	3
Mississippi	4,742	$108.40	$86.36	4
Washington	3,300	$108.54	$86.48	3
North Dakota	2,640	$108.34	$86.32	2
District of Columbia	1,620	$108.54	$86.48	2
Minnesota	1,360	$108.55	$86.49	1
Wyoming	1,220	$108.02	$86.06	1
Montana	1,080	$108.57	$86.42	1

Related codes

J2777Injection, faricimab-svoa, 0.1 mg$34.37
J2781Injection, pegcetacoplan, intravitreal, 1 mg$146.64
J2785Injection, regadenoson, 0.1 mg$6.76
J2704Injection, propofol, 10 mg$0.11
J2778Injection, ranibizumab, 0.1 mg$159.00
J2795Injection, ropivacaine hydrochloride, 1 mg$0.07
J2796Injection, romiplostim, 10 micrograms$96.86
J2720Injection, protamine sulfate, per 10 mg$1.54

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.