Vabysmo Cost: $1,879.32 a Dose at Medicare's Own Price
Medicare allows $1,879.32 for the drug in one Vabysmo injection plus $114.23 for the shot, so $1,993.55 a visit. On Original Medicare your share is $398.71 every time, with no yearly cap. Vabysmo is the most expensive of the common wet AMD drugs per dose, and it is sold on needing fewer of them. Below is whether that trade actually saves you money, from CMS's published October 2026 payment file.
- Vabysmo bills under J2777 at $31.322 per 0.1 mg, and the dose is 6 mg, so a correct claim for one eye shows exactly 60 units. That is the highest unit count of any retina drug and the easiest one to get wrong.
- A year in one eye runs about $2,390 to $2,790 of your own money in Part B coinsurance. Even on a stretched 16-week schedule, the per-dose price keeps the annual total above Eylea's.
- Vabysmo is a Genentech drug, so if you are uninsured or underinsured the Genentech Patient Foundation may supply it free, shipped to your retina clinic. That is the single largest lever available on this bill.
What One Vabysmo Injection Is Allowed
Part B pays for Vabysmo off a payment limit CMS republishes every quarter (average sales price plus 6%). These are the limits in force October 1 through December 31, 2026, in a retina practice's own office.
| Line item | Amount |
|---|---|
| Billing code | J2777 |
| Payment limit per 0.1 mg | $31.322 |
| Standard dose | 6 mg |
| Units on a correct claim, one eye | 60 |
| Drug allowed | $1,879.32 |
| Injection, CPT 67028 (office) | $114.23 |
| Total allowed, one eye | $1,993.55 |
| Your 20% on Original Medicare | $398.71 |
Source: CMS October 2026 Medicare Part B payment limit file (2Q26 ASP data) and the 2026 physician fee schedule (CPT 67028, 3.42 non-facility RVUs at the $33.4009 conversion factor). Vabysmo's limit has edged down through 2026: $32.866 in January, $32.556 in April, $32.381 in July, $31.322 now.
Want to know what your Vabysmo (faricimab) eye injection should cost you?
Costs vary substantially by procedure, location, facility, and insurance. Get a personalized estimate based on your situation.
Already have a bill? Send it to CareRoute and we will work to reduce it. 64% of cases reduced.
The 60 Units Problem
Most drugs are billed in units you can eyeball. Vabysmo is not. Because the code is priced per 0.1 mg and the dose is 6 mg, one injection is 60 units at $31.322 each. That multiplier makes a small clerical slip expensive:
| If the claim shows | Drug allowed |
|---|---|
| 60 units | $1,879.32 |
| 120 units | $3,758.64 |
| 600 units | $18,793.20 |
On a statement that already says $1,879 for one shot, a $18,793 line does not look absurd to anybody who is not checking the code definition. Pull the explanation of benefits, find the J2777 line, and read the unit column. Then confirm CPT 67028 appears once per eye with an RT or LT modifier. Our infusion bill guide walks the same audit for every drug billed this way.
Does the Longer Interval Save You Money?
Vabysmo's selling point is durability: four monthly loading doses, then intervals that can stretch to every 12 or 16 weeks. In published trials the real-world first-year count came out around 6 to 7 injections, which is about the same as Eylea 2 mg and ranibizumab. The visits go down; the per-dose price is what decides the money.
| One eye, first year | Allowed total | Your 20% |
|---|---|---|
| Vabysmo, 6 injections | $11,961.30 | $2,392.26 |
| Vabysmo, 7 injections | $13,954.85 | $2,790.97 |
| For comparison: Eylea, 6 injections | $9,352.39 | $1,870.48 |
| For comparison: compounded Avastin, 6 injections | about $1,050 | about $210 |
Fewer visits is a real benefit, just not a financial one
Fewer trips to the retina clinic matters, especially if someone has to drive you. But if the pitch you heard was that stretching the interval lowers the cost, ask for the arithmetic on your schedule before you accept it. At 6 injections Vabysmo costs you about $520 a year more than Eylea and about $2,180 more than compounded bevacizumab, per eye.
Part B has no annual out-of-pocket maximum. It pays 80% after the 2026 deductible of $283 and your 20% simply continues, year after year, doubled if both eyes are treated.
Where You Get the Shot Changes the Bill
The $1,879.32 of drug is the same anywhere. The rest is not. In the retina practice's office the injection is allowed $114.23 and that is the whole non-drug charge. In a hospital outpatient department the physician's portion drops to $75.49 and the hospital adds a facility fee on top, normally the larger of the two. If a routine injection is being scheduled at a hospital clinic rather than the office, ask why.
How to Pay Less
Uninsured or underinsured: ask for the free drug program
Vabysmo is made by Genentech, and the Genentech Patient Foundation provides Genentech drugs free to patients who qualify on income, with no citizenship requirement, shipped to your retina clinic: (888) 941-3331. It is income-tested and not guaranteed, but it is the biggest single lever here and most patients never hear about it. Note that the foundation is separate from Genentech Access Solutions, which handles benefits and copay support for insured patients.
Commercial insurance: the manufacturer copay program
The Vabysmo copay program can cover most or all of your coinsurance if your plan is commercial. Your clinic usually enrolls you. Check your plan for a copay accumulator or maximizer clause, which can stop that assistance from counting toward your deductible and out-of-pocket maximum.
Medicare: a charity fund, because the copay card is barred
Federal rules prohibit manufacturer copay assistance for Medicare patients, so the copay program will turn you away. What works is an independent foundation with an open macular degeneration or retinal disease fund: the PAN Foundation, HealthWell Foundation, and Good Days. They close when funding runs out, so apply the day you find one open. Our medication assistance checker routes by coverage type.
Ask what else would work for you
Vabysmo is the priciest per dose of the common options. Compounded bevacizumab is a fraction of it and brand Lucentis is currently the cheapest branded drug in the class. Which one is right is a medical decision, but at a difference of $2,000 a year in your own coinsurance it is a fair question to raise. See all eye injection costs side by side.
Already have the bill
A 60-unit drug line is where coding errors hide. CareRoute Bill Defense checks the units and modifiers, pursues the denial if there is one, and negotiates the balance. Free to submit, and you only pay if we reduce it.
Frequently Asked Questions
How much does Vabysmo cost per injection?
Medicare's payment limit for October through December 2026 is $31.322 per 0.1 mg of faricimab (code J2777). The standard dose is 6 mg, which is 60 billing units, so the drug is allowed $1,879.32. Adding $114.23 for the injection procedure in a doctor's office brings one treatment to $1,993.55. On Original Medicare you owe 20%, which is $398.71 per injection per eye.
How many units of J2777 should my bill show?
Sixty, for one eye. J2777 is priced per 0.1 mg and the Vabysmo dose is 6 mg. If the claim shows 120 units, both eyes should have been injected at that visit, which you can confirm by looking for a modifier 50 or two lines carrying RT and LT. If it shows 600 units, the dose was almost certainly entered in milligrams against a code priced in tenths, and the charge is ten times what it should be. CPT 67028 should appear once per eye.
Does Medicare cover Vabysmo?
Yes, under Part B rather than a Part D plan, because a clinician injects it. Part B pays 80% of the allowed amount after the 2026 annual deductible of $283 and you owe the other 20%, with no annual out-of-pocket maximum. A Medigap policy, a Medicare Advantage plan, retiree coverage, or Medicaid is what limits your exposure. Medicare Advantage plans may require prior authorization or step therapy through another anti-VEGF drug first.
Is Vabysmo cheaper than Eylea because you need fewer injections?
Usually not. Vabysmo costs more per dose ($1,993.55 allowed against $1,558.73 for Eylea), and published real-world first-year injection counts for faricimab came in around 6 to 7, close to Eylea 2 mg. At six injections a year in one eye your coinsurance is about $2,392 on Vabysmo against $1,870 on Eylea. The longer interval buys fewer clinic visits, which is a genuine benefit, but it does not usually lower the bill.
What does a year of Vabysmo cost?
At six injections in one eye, Medicare's allowed total is $11,961.30 and your 20% is $2,392.26. At seven it is $13,954.85 allowed and $2,790.97 to you. Double either figure if both eyes are treated. On a commercial plan your share stops at your out-of-pocket maximum; on Original Medicare without a supplement it does not stop at all.
Can I get Vabysmo free or at reduced cost?
If you are uninsured or underinsured, the Genentech Patient Foundation may provide Vabysmo free based on income, with no citizenship requirement, shipped to your clinic: (888) 941-3331. If you have commercial insurance, the manufacturer copay program can cover most of your coinsurance. If you have Medicare, manufacturer copay help is not legally available, and the working route is an independent charity fund for macular degeneration or retinal disease, such as the PAN Foundation, HealthWell Foundation, or Good Days.
Related Guides
Sources
- CMS, October 2026 Medicare Part B Payment Limit File (ASP pricing file), effective October 1 to December 31, 2026, based on 2Q26 ASP data: J2777 $31.322 per 0.1 mg, J0178 $722.251 per 1 mg. January, April, and July 2026 files for the quarterly trend.
- CMS, 2026 National Physician Fee Schedule Relative Value File (October release): CPT 67028, 3.42 non-facility and 2.26 facility total RVUs, conversion factor $33.4009.
- FDA prescribing information for Vabysmo (faricimab-svoa), 6 mg dose and loading plus extended interval schedule.
- Published real-world and trial first-year injection counts for faricimab, aflibercept, ranibizumab, and brolucizumab.
- Genentech Patient Foundation program terms, verified free-drug eligibility and intake line (888) 941-3331.
- CMS, 2026 Medicare Parts A and B premiums and deductibles (Part B deductible $283).
Medicare payment limits are republished quarterly; these are the October to December 2026 figures. Commercial plans pay their own negotiated rates, usually higher. Assistance programs are income-tested and can close without notice. Which drug is right for you is a decision for you and your retina specialist. This is cost information, not medical advice. Last updated November 12, 2026.