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Market snapshot

J2781 in CA CY2024

Medicare Part B FFS · CY2024 · as published by CMS

J2781 — Injection, pegcetacoplan, intravitreal, 1 mg

Billing groups
26
Named-group FFS services
158,051
FFS of Medicare
49%
Services YoY
+483.0%
FFS enrollment +0.0%
Estimated all-Medicare volume FFS + estimated MA estimate
~320,664 services

158,051 observed fee-for-service (49%) · ~162,613 estimated Medicare Advantage. Scaled from the observed floor by each state’s fee-for-service share (FFS share as of 2024) — scaled estimate — assumes MA utilization mirrors FFS; not an observation. How we scale

Named-group submitted charges
$54.4M
Named-group allowed amount
$23.2M
Named-group Medicare payments
$18.4M
Avg charge / svc
$344
Avg allowed / svc
$147
Avg payment / svc
$117
Average charge per group
$154 26 groups · avg submitted charge / service $653
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Data year: CY2024 CY2023 CY2022 🔒 CY2021 🔒 CY2020 🔒
Physician groups ranked by J2781 services, CY2024
#Physician group City Specialty Providers J2781 svcs Submitted charges Avg charge Medicare $ locked column Share* Phone
1 VITREO-RETINAL MEDICAL GROUP, INC. YUBA CITY OPHTHALMOLOGY 21 26,355 $8,170,050 $310 premium 10.3% (530) 273-8358
2 RETINA CONSULTANTS SAN DIEGO INC POWAY OPHTHALMOLOGY 5 21,445 $8,887,375 $414 premium 8.4% (858) 451-1911
3 RETINA VITREOUS ASSOCIATES MEDICAL GROUP LOS ANGELES OPHTHALMOLOGY 17 16,455 $6,582,000 $400 premium 6.4% (213) 483-8810
4 ORANGE COUNTY RETINA MEDICAL GROUP SAN JUAN CAPISTRANO OPHTHALMOLOGY 4 14,595 $2,919,000 $200 premium 5.7% (949) 496-0611
5 RETINA CONSULTANTS OF ORANGE COUNTY, A MEDICAL CORPORATION FULLERTON OPHTHALMOLOGY 7 11,475 $3,476,122 $303 premium 4.5% (714) 738-4620
6 RIVERSIDE EYECARE PROFESSIONALS INC A MEDICAL CORPORATION REDDING OPHTHALMOLOGY 3 9,450 $2,201,850 $233 premium 3.7% (530) 244-2273
7 JEFFREY V. WINSTON, M.D., A PROFESSIONAL CORP. FULLERTON OPTOMETRY 7 7,905 $5,159,100 $653 premium 3.1% (714) 888-2080
8 CALIFORNIA RETINA CONSULTANTS SANTA BARBARA OPHTHALMOLOGY 11 7,290 $3,207,600 $440 premium 2.9% (805) 963-1648
9 RETINA INSTITUTE OF CALIFORNIA MEDICAL GROUP, A CALIFORNIA MEDICAL PAR PASADENA OPHTHALMOLOGY 82 7,170 $3,340,870 $466 premium 2.8% (800) 898-2020
10 RETINAL DIAGNOSTIC CENTER A MEDICAL CORPORATION CAMPBELL OPHTHALMOLOGY 6 6,330 $1,856,842 $293 premium 2.5% (408) 559-0666
11 PACIFIC EYE INSTITUTE A MEDICAL GROUP INC UPLAND OPHTHALMOLOGY 47 4,846 $1,283,392 $265 premium 1.9% (909) 982-8846
12 BAY AREA RETINA ASSOCIATES VALLEJO OPHTHALMOLOGY 8 2,955 $680,477 $230 premium 1.2% (707) 552-9596
13 SUTTER BAY MEDICAL FOUNDATION PALO ALTO INTERNAL MEDICINE 3716 2,505 $732,105 $292 premium 1.0% (415) 600-1020
14 INLAND VALLEY RETINA MEDICAL ASSOCIATES, INC TEMECULA OPHTHALMOLOGY 3 2,310 $462,000 $200 premium 0.9% (951) 679-0400
15 CHA MEDICAL AND SURGICAL GROUP PC LOS ANGELES OPHTHALMOLOGY 11 2,295 $803,250 $350 premium 0.9% (323) 644-4445
16 DELTA EYE MEDICAL GROUP, INC. STOCKTON OPHTHALMOLOGY 8 2,091 $322,014 $154 premium 0.8% (209) 478-1797
17 SCRIPPS HEALTH LA JOLLA PHYSICIAN ASSISTANT 1431 1,892 $957,144 $506 premium 0.7% (858) 455-9100
18 MIRAMAR EYE SPECIALISTS MEDICAL GROUP INC VENTURA OPHTHALMOLOGY 25 1,860 $604,140 $325 premium 0.7% (805) 648-3085
19 RETINA MACULA INSTITUTE TORRANCE OPHTHALMOLOGY 5 1,830 $561,883 $307 premium 0.7% (310) 944-9393
20 CARSON MCBEATH AND BOSWELL INC LONG BEACH OPHTHALMOLOGY 8 1,395 $372,465 $267 premium 0.5% (562) 984-7024
21 HARVARD EYE ASSOCIATES FKA ROGER OHANESIAN MD AND EDWARD KIM MD INC SAN CLEMENTE OPHTHALMOLOGY 20 1,320 $481,800 $365 premium 0.5% (949) 951-2020
22 VANTAGE EYE CENTER A MEDICAL CORP MONTEREY OPHTHALMOLOGY 19 1,065 $400,440 $376 premium 0.4% (831) 647-3900
23 KENNETH R GROSSMAN MD INC MERCED OPHTHALMOLOGY 2 877 $276,110 $315 premium 0.3% (209) 383-0989
24 RETINA ASSOCIATES OF FLORIDA, P.A. TAMPA OPHTHALMOLOGY 3 870 $174,000 $200 premium 0.3% (813) 875-6373
25 MEHRAN TABAN MD INC TORRANCE OPHTHALMOLOGY 2 855 $342,000 $400 premium 0.3% (424) 247-9090
26 THE RETINA PARTNERS ENCINO OPHTHALMOLOGY 6 615 $102,502 $167 premium 0.2% (818) 788-9333

*Share of the state's disclosed Medicare-FFS services for the primary code, counted once per clinician. "St" is the state the volume was billed from: a group appears in each state where its clinicians bill Medicare, with that state's volume and share ("City" is the group's registered location). Group figures sum clinicians affiliated with exactly one group; clinicians in several groups are listed in each group's drill-down but not volume-attributed to any single group, so shares reflect attributable volume. See Methods.

Comparing against an all-payer estimate?

These are exact counts from Medicare fee-for-service claims — roughly a third to half of most procedure markets, depending on payer mix. Modeled all-payer databases project the remainder statistically; we publish the audited floor and label it as such. Same market, different denominator. How the numbers reconcile →