Cost analysis for CPT Q5128 — Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg
Average Medicare Payment
$216.45
2023 data
Total Payments (2023)
$95.8M
Services (2023)
442.2K
Price Change (2023–2023)
0.0%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2023 | $216.45 | $95.8M | 442.2K | — |
The most expensive state pays 1.1x more than the cheapest for this procedure. IN averages $236.66 vs MD at $213.30.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| IN | $236.66 | $1.2M | 5.2K | 7 |
| KS | $221.02 | $250.4K | 1.1K | 3 |
| UT | $219.98 | $276.3K | 1.3K | 4 |
| CA | $218.05 | $14.3M | 65.7K | 50 |
| OR | $217.69 | $126.3K | 580 | 2 |
| LA | $217.26 | $249.0K | 1.1K | 2 |
| MN | $217.05 | $6.7M | 30.8K | 17 |
| TX | $217.01 | $14.2M | 65.6K | 54 |
| GA | $216.91 | $295.9K | 1.4K | 3 |
| FL | $216.86 | $8.9M | 40.9K | 41 |
| SC | $216.56 | $3.8M | 17.7K | 14 |
| ID | $216.54 | $108.5K | 501 | 1 |
| WA | $216.48 | $1.8M | 8.2K | 13 |
| OK | $216.36 | $728.9K | 3.4K | 4 |
| NY | $216.33 | $5.4M | 24.8K | 20 |
| CO | $216.27 | $837.0K | 3.9K | 11 |
| PA | $216.19 | $18.5M | 85.3K | 22 |
| CT | $216.12 | $525.8K | 2.4K | 5 |
| NC | $216.08 | $334.5K | 1.5K | 4 |
| AZ | $215.97 | $3.3M | 15.4K | 16 |
| NV | $215.47 | $95.0K | 441 | 1 |
| VA | $215.44 | $565.5K | 2.6K | 8 |
| MO | $215.38 | $460.1K | 2.1K | 3 |
| AL | $215.32 | $1.3M | 6.0K | 2 |
| OH | $215.09 | $49.5K | 230 | 1 |
| MI | $215.03 | $148.2K | 689 | 3 |
| MS | $214.92 | $349.2K | 1.6K | 4 |
| NJ | $214.80 | $2.1M | 9.7K | 15 |
| MA | $214.66 | $143.8K | 670 | 2 |
| HI | $214.64 | $80.3K | 374 | 1 |
| TN | $214.52 | $6.7M | 31.2K | 17 |
| IL | $214.30 | $566.8K | 2.6K | 4 |
| MD | $213.30 | $1.5M | 6.9K | 19 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Omesh Gupta | Ophthalmology | PA | $1.8M | 8.4K | $216.15 |
| David Williams | Ophthalmology | MN | $1.7M | 8.0K | $217.48 |
| Richard Kaiser | Ophthalmology | PA | $1.7M | 8.0K | $216.42 |
| Homayoun Tabandeh | Ophthalmology | CA | $1.6M | 7.4K | $219.39 |
| Stephen Couvillion | Ophthalmology | CA | $1.5M | 7.1K | $219.00 |
| Yoshihiro Yonekawa | Ophthalmology | PA | $1.4M | 6.3K | $215.94 |
| Mitchell Fineman | Ophthalmology | PA | $1.4M | 6.3K | $216.55 |
| Nathan Steinle | Ophthalmology | CA | $1.3M | 6.0K | $217.23 |
| Marc Spirn | Ophthalmology | PA | $1.3M | 6.0K | $216.51 |
| James Vander | Ophthalmology | PA | $1.3M | 6.0K | $216.64 |
| Peter Nixon | Ophthalmology | TX | $1.1M | 4.9K | $216.90 |
| Carl Regillo | Ophthalmology | PA | $1.1M | 4.9K | $215.52 |
| Sunir Garg | Ophthalmology | PA | $1.0M | 4.8K | $216.55 |
| Brandon Busbee | Ophthalmology | TN | $1.0M | 4.8K | $212.88 |
| Alessandro Castellarin | Ophthalmology | CA | $1.0M | 4.6K | $218.33 |
| Sunil Patel | Ophthalmology | TX | $973.8K | 4.5K | $218.15 |
| Abdhish Bhavsar | Ophthalmology | MN | $963.8K | 4.4K | $217.32 |
| Jonathan Jonisch | Ophthalmology | NY | $934.3K | 4.3K | $216.12 |
| Duo Xu | Ophthalmology | PA | $914.6K | 4.2K | $215.65 |
| Allen Chiang | Ophthalmology | PA | $885.5K | 4.1K | $216.60 |
Based on the data, CPT Q5128 shows a 1.1x 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.