J2781

CPT/HCPCS

Injection, pegcetacoplan, intravitreal, 1 mg

Physician Fee Schedule

Facility

Medicare Payment

$120.36

Submitted Charge$372.90
Medicare Allowed$151.06
Providers3
Beneficiaries21
Total Services690
Office

Medicare Payment

$119.92

Submitted Charge$297.16
Medicare Allowed$150.51
Providers1,418
Beneficiaries17,176
Total Services501,009