Eye Care Coding Reference
CPT 67028 intravitreal injection.
What the code covers, its zero-day global period, bilateral and laterality rules, billing the drug with its HCPCS code, JW and JZ modifiers, same-day exams and NCCI bundling. Last reviewed October 2026.
In one paragraph
The code for injecting a drug into the vitreous.
CPT 67028 covers injecting a drug into the vitreous cavity of the eye, the procedure behind most anti-VEGF and complement inhibitor treatments. Medicare lists it with a zero-day global period and allows a bilateral payment adjustment. The drug is billed separately with its own HCPCS code and units, plus a JW or JZ modifier for single-dose containers. Same-day exams are included unless a significant, separately identifiable service is documented with modifier 25. Descriptions on this page are Vision Rescue summaries, not the official CPT descriptor.
67028 at a glance
- Global period: 0 days
- Eye modifiers: RT, LT or 50 per payer
- Medicare bilateral: one line with modifier 50 and 1 unit
- Drug billed separately with its HCPCS code
- JW or JZ on single-dose drug lines
- Not reported for injections during cataract surgery
The zero-day global period.
Medicare treats 67028 as a minor procedure with a zero-day global period. Only the day of the injection is in the package, so follow-up visits on later days are billed on their own.
Included on the day of the injection
- The injection and the routine prep that goes with it
- The usual pre-injection check of a patient already scheduled for treatment
- A subconjunctival injection on the same eye
- An anterior chamber paracentesis on the same eye at the same encounter
When a same-day exam may be billed
- The exam is significant and separately identifiable from the injection
- The exam is what determined that an injection was needed
- The fellow eye is examined for its own medical reason
- The record supports the visit on its own, with modifier 25 on the exam
An exam that only confirms a previously planned injection is part of 67028. Under NCCI policy for minor procedures, the decision to perform the procedure is included in its payment.
Laterality and bilateral injections.
Medicare's fee schedule gives 67028 a bilateral indicator, so bilateral same-day injections are paid with the bilateral adjustment. How the claim is formatted depends on the payer.
| Payer approach | How the injection lines look |
|---|---|
| Medicare Part B | 67028 with modifier 50 on one line, 1 unit, with the charge for both eyes |
| Some commercial and Medicare Advantage plans | Two lines, 67028 with RT and 67028 with LT |
| Other payers | Two lines, 67028 and 67028 with modifier 50 |
| One eye only | 67028 with RT or LT |
First Coast policy states that claims for 67028 without RT, LT or 50 are returned unprocessed. For the drug, most Medicare contractors accept one line with the units for both eyes added together, while some payers want a separate drug line for each eye. Only add RT or LT to drug lines when the payer asks for it.
Drug codes and units.
The injected drug is billed on its own line with its HCPCS code. Units come from the dose in the code descriptor, so a 6 mg dose of a drug billed per 0.1 mg is 60 units.
| HCPCS | CMS descriptor | Example product |
|---|---|---|
| J0178 | Injection, aflibercept, 1 mg | Eylea |
| J0177 | Injection, aflibercept hd, 1 mg | Eylea HD |
| Q5147 | Injection, aflibercept-ayyh (pavblu), biosimilar, 1 mg | Pavblu |
| J2778 | Injection, ranibizumab, 0.1 mg | Lucentis |
| Q5124 | Injection, ranibizumab-nuna, biosimilar, (byooviz), 0.1 mg | Byooviz |
| Q5128 | Injection, ranibizumab-eqrn (cimerli), biosimilar, 0.1 mg | Cimerli |
| J2777 | Injection, faricimab-svoa, 0.1 mg | Vabysmo |
| J2781 | Injection, pegcetacoplan, intravitreal, 1 mg | Syfovre |
| J2782 | Injection, avacincaptad pegol, 0.1 mg | Izervay |
| J9035 | Injection, bevacizumab, 10 mg | Avastin |
| C9257 | Injection, bevacizumab, 0.25 mg | Avastin, repackaged for the eye |
Bevacizumab coding varies by contractor and setting. Some contractors tie C9257 to hospital outpatient and ASC claims and point office claims to J9035 or an unlisted drug code such as J7999 or J3490. Check your contractor's coverage article. Other biosimilar Q codes are added through quarterly HCPCS updates.
JW, JZ and NDC reporting.
Medicare requires a waste modifier on separately payable drugs from single-dose containers.
JW and JZ
| Modifier | When it applies |
|---|---|
| JZ | No drug was discarded; one line with the units given. Required since July 1, 2023 |
| JW | Drug was discarded; a second line with the discarded units. Required since January 1, 2017 |
| Neither | Multi-dose containers and drugs packaged into a facility payment |
Overfill is never billed. JW is not used when the dose given is smaller than one billing unit; the full unit is billed with JZ. Since October 1, 2023, Medicare claims missing the right modifier may be returned. Record the discarded amount in the chart.
NDC on the drug line
- Many payers expect the 11-digit NDC in 5-4-2 format with the N4 qualifier
- Report the NDC for the exact package used, since vial and syringe NDCs differ
- Unlisted drug codes need the drug name, dose and often an invoice in item 19
- Free samples are not billed to the payer
NCCI bundling notes.
The 2026 Medicare NCCI Policy Manual, Chapter 8, includes these rules for 67028.
- Injecting an antibiotic, steroid or NSAID during cataract surgery or another eye procedure is part of that procedure; 67028 is not reported for it
- An anterior chamber paracentesis on the same eye at the same encounter is not reported with 67028
- A subconjunctival injection on the same eye is not reported separately with 67028
- Anesthetic injections are part of the procedure they support
67028 is designated a separate procedure, and some commercial payers deny it when another procedure is done the same day. Payers also apply drug labels and their own frequency policies, and off-label use is often denied unless the payer's policy covers it.
The code itself did not change. Medicare's 2026 fee schedule applied an efficiency adjustment to most procedure codes and shifted indirect practice expense toward office-based services. Drug codes keep changing through quarterly HCPCS updates as new biosimilars arrive.
From Vision Rescue Pro
Supplies for retina practices.
Separate from the coding information above. Vision Rescue Pro is a licensed distributor of injection prep supplies and patient care products for retina practices. We do not sell the injected drugs listed above.
- Injection prep supplies such as povidone-iodine and lidocaine jelly
- Retina Alliance member pricing
- AREDS2 vitamins for patients through RescueLink
- Price Match Guarantee
Questions about CPT 67028
What is CPT code 67028?
It is the code for injecting a drug into the vitreous cavity of the eye. It is used for most anti-VEGF and complement inhibitor treatments.
What is the global period for 67028?
Zero days. Only the day of the injection is in the package, so visits on later days are billed separately.
How do you bill 67028 bilaterally?
Medicare expects one line with modifier 50 and 1 unit, paid with the bilateral adjustment. Some other payers want two lines with RT and LT. Follow each payer's rules.
What J code goes with 67028?
The drug is billed on its own line with its HCPCS code, such as J0178 for aflibercept, J2777 for faricimab or J2778 for ranibizumab. Units follow the dose in the descriptor.
Can you bill an exam with 67028 on the same day?
Yes, with modifier 25, when the exam is significant and separately identifiable, such as one that determines the need for the injection. An exam that only confirms a planned injection is included.
Do I need JW or JZ with intravitreal drugs?
For separately payable drugs from single-dose containers, Medicare requires JZ when nothing was discarded and JW on a separate line for discarded units.
Can 67028 be billed with cataract surgery?
Not for drugs injected during the cataract procedure. NCCI policy treats those injections as part of the surgery.
Sources
CMS Medicare Physician Fee Schedule indicators for 67028; CMS MLN Global Surgery Booklet (MLN907166); Medicare NCCI Policy Manual, Chapter 8, 2026; First Coast Service Options LCD L36962 coding guidelines, VEGF Inhibitors for the Treatment of Ophthalmological Diseases; First Coast guidance on JW and JZ modifiers; CMS HCPCS code set, 2026; AAO practice management guidance on bilateral injections; Retina Today coding articles on bilateral rules, modifier 25 and clean claims; Retinal Physician coding column on bevacizumab and discarded drugs; Review of Ophthalmology, Coding and Reimbursement 2026 Update.
Notes and disclosures
CPT is a registered trademark of the American Medical Association. Descriptions here are Vision Rescue summaries, not official CPT descriptors. This page is general information for eye care professionals and billing staff, not legal, billing or coding advice. Payer rules vary; verify codes, modifiers and coverage with the current official code sets, your Medicare contractor and the patient's plan. Questions: providers@visionrescue.com or 1-855-692-8024.
Code the injection right, then prep the room.
Injection prep supplies, member pricing and patient follow-through for retina practices.