Cost analysis for CPT J2781 — Injection, pegcetacoplan, intravitreal, 1 mg
Average Medicare Payment
$119.93
2023 data
Total Payments (2023)
$49.8M
Services (2023)
415.2K
Price Change (2023–2023)
0.0%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2023 | $119.93 | $49.8M | 415.2K | — |
The most expensive state pays 1.3x more than the cheapest for this procedure. AR averages $120.36 vs AL at $89.22.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AR | $120.36 | $227.5K | 1.9K | 3 |
| NE | $120.36 | $191.4K | 1.6K | 4 |
| WV | $120.36 | $97.5K | 810 | 1 |
| DE | $120.36 | $86.7K | 720 | 1 |
| MT | $120.36 | $52.4K | 435 | 1 |
| KS | $120.36 | $207.9K | 1.7K | 3 |
| KY | $120.36 | $193.4K | 1.6K | 4 |
| NJ | $120.36 | $1.6M | 13.3K | 18 |
| MA | $120.36 | $469.4K | 3.9K | 4 |
| MI | $120.36 | $95.7K | 795 | 3 |
| IL | $120.36 | $1.1M | 9.4K | 13 |
| AK | $120.36 | $21.7K | 180 | 1 |
| NV | $120.36 | $133.6K | 1.1K | 2 |
| PA | $120.36 | $2.1M | 17.2K | 19 |
| IA | $120.36 | $99.3K | 825 | 1 |
| ND | $120.36 | $57.9K | 481 | 1 |
| MO | $120.36 | $326.9K | 2.7K | 5 |
| SD | $120.36 | $724.0K | 6.0K | 3 |
| ME | $120.36 | $278.0K | 2.3K | 3 |
| NM | $120.36 | $186.0K | 1.5K | 3 |
| WA | $120.36 | $1.2M | 10.3K | 14 |
| CT | $120.33 | $612.2K | 5.1K | 11 |
| VA | $120.28 | $1.6M | 13.0K | 18 |
| MD | $120.27 | $4.4M | 36.5K | 17 |
| MN | $120.27 | $312.3K | 2.6K | 5 |
| TX | $120.25 | $6.2M | 51.5K | 47 |
| UT | $120.25 | $1.9M | 15.8K | 15 |
| TN | $120.24 | $1.5M | 12.3K | 18 |
| IN | $120.21 | $335.4K | 2.8K | 8 |
| CA | $120.19 | $5.3M | 43.8K | 55 |
| OR | $120.17 | $1.1M | 9.4K | 11 |
| OH | $120.03 | $2.6M | 21.6K | 17 |
| NC | $120.03 | $682.6K | 5.7K | 9 |
| CO | $120.02 | $1.1M | 9.3K | 14 |
| GA | $119.90 | $348.9K | 2.9K | 8 |
| ID | $119.89 | $922.8K | 7.7K | 6 |
| AZ | $119.82 | $738.9K | 6.2K | 8 |
| FL | $119.75 | $4.8M | 40.0K | 47 |
| MS | $119.65 | $425.5K | 3.6K | 3 |
| OK | $119.52 | $337.1K | 2.8K | 5 |
| NY | $119.49 | $2.7M | 22.6K | 36 |
| SC | $119.03 | $1.9M | 16.1K | 15 |
| LA | $118.96 | $430.0K | 3.6K | 5 |
| WI | $118.52 | $131.8K | 1.1K | 3 |
| AL | $89.22 | $25.1K | 281 | 2 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| David Warrow | Ophthalmology | MD | $1.8M | 15.2K | $120.29 |
| Allen Hu | Ophthalmology | MD | $1.2M | 10.1K | $120.34 |
| Sunil Gupta | Ophthalmology | FL | $839.7K | 7.0K | $119.88 |
| Jason Ysasaga | Ophthalmology | TX | $663.4K | 5.5K | $119.85 |
| Eric Jablon | Ophthalmology | SC | $603.0K | 5.0K | $120.36 |
| David Kim | Ophthalmology | CA | $529.0K | 4.4K | $120.36 |
| Prema Abraham | Ophthalmology | SD | $520.0K | 4.3K | $120.36 |
| David Brown | Ophthalmology | TX | $491.1K | 4.1K | $120.36 |
| Robert Reinauer | Ophthalmology | TX | $451.6K | 3.8K | $120.36 |
| David Miller | Ophthalmology | OH | $415.2K | 3.5K | $120.36 |
| Nathan Steinle | Ophthalmology | CA | $408.0K | 3.4K | $120.36 |
| Scott Pendergast | Ophthalmology | OH | $390.0K | 3.2K | $120.36 |
| Charles Wykoff | Ophthalmology | TX | $377.3K | 3.1K | $120.35 |
| Matthew Benz | Ophthalmology | TX | $359.3K | 3.0K | $120.36 |
| Douglas Mehr | Ophthalmology | UT | $351.6K | 2.9K | $120.36 |
| Gordon Byrnes | Ophthalmology | VA | $335.8K | 2.8K | $120.36 |
| Kyle Thompson | Ophthalmology | ID | $335.8K | 2.8K | $120.36 |
| Thomas Shane | Ophthalmology | FL | $326.8K | 2.7K | $120.36 |
| David Boyer | Ophthalmology | CA | $321.4K | 2.7K | $120.36 |
| Babak Jian Seyedahmadi | Ophthalmology | MA | $301.5K | 2.5K | $120.36 |
Based on the data, CPT J2781 shows a 1.3x variation in pricing across states — relatively consistent by Medicare standards.
Costs have decreased 0% since 2023. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.