Vabysmo (faricimab-svoa) is Genentech’s anti-VEGF drug for wet age-related macular degeneration, diabetic macular edema, and macular edema following retinal vein occlusion. A retina specialist injects 6 mg into the eye, and treatment continues on a schedule your doctor sets, often for years.
For anyone paying cash, that structure creates two separate bills that people routinely confuse. There is the drug, which is expensive and priced nationally. And there is the procedure of putting it into your eye, which is a different billing code with its own price that changes a lot depending on whether you sit in a doctor’s office or a hospital outpatient department. This guide separates them and shows the arithmetic. Everything below was researched September 3, 2026.
What Does Vabysmo Cost Without Insurance?
Medicare pays for Vabysmo under HCPCS code J2777, and the billing unit is 0.1 mg. One 6 mg vial is therefore 60 billing units, which CMS’s own NDC-HCPCS crosswalk confirms for Genentech’s Vabysmo NDC. The Part B payment limit effective July 1 through September 30, 2026 is $32.381 per 0.1 mg, so 60 units x $32.381 = $1,942.86 for one dose.
Genentech publishes its own figure. Vabysmo.com states that the current price of Vabysmo is $2,483.74 per treatment, footnoted “as of July 2026.” That is the highest of the three national numbers and about 28% above Medicare’s allowance.
| Vabysmo cost item | Low | Average | High |
|---|---|---|---|
| Vabysmo drug, one 6 mg dose | $1,942.86 (CMS Part B limit) | $2,419.05 (CMS 2024 per claim) | $2,483.74 (Genentech list) |
| Injection fee only, CPT 67028, Medicare rates | $114.23 (physician office) | $114.23 | $337.46 (hospital outpatient) |
| Drug plus office injection fee, one eye | $2,057.09 | $2,533.28 | $2,597.97 |
| Bundled cash price for an eye injection (MDsave) | $665 | $1,443 | $1,832 |
| One year of treatment, CMS 2024 Medicare average per beneficiary | $11,119.52 | $11,119.52 | $11,119.52 |
| Genentech Ophthalmology Co-pay Program (commercial insurance required) | $0 | $0 | $0 |
For a reality check on those numbers, CMS’s Medicare Part B spending data for 2024 shows $1.92 billion in Vabysmo spending across 792,936 claims and 172,503 beneficiaries. That is an average of $2,419.05 per claim and $11,119.52 per beneficiary for the year, which lands between Medicare’s per-dose allowance and Genentech’s list price. Part of the gap is that some claims cover both eyes on the same visit, so the per-claim average runs above a single-eye dose.
The injection fee is a separate bill
Someone has to perform the injection, and that is CPT 67028, intravitreal injection of a pharmacologic agent. CMS’s July 2026 relative value file assigns 67028 a total of 3.42 non-facility relative value units, which at the 2026 conversion factor of $33.4009 works out to $114.23 in a physician office.
In a hospital outpatient department the math is different. The July 2026 OPPS Addendum B pays the facility $337.46 for 67028 under APC 5694, and the physician bills a separate professional fee on top of that at the lower facility rate of about $75.49. Same needle, same drug, roughly triple the procedure cost.
Cash bundles are a third world entirely. MDsave’s national listing for an intravitreal injection ranged from $665 to $1,832 with a national average of $1,443 when checked twice on September 3, 2026. Bundles differ in what they include, so confirm in writing whether the drug is in the price before you buy one.
What Drives the Price
Quarterly ASP resets. Medicare’s Part B payment limit for J2777 is rebuilt every quarter from manufacturer-reported average sales price data. The July 2026 file is built on first-quarter 2026 data. The April 2026 file paid $32.556 per 0.1 mg, which was $1,953.36 per dose, so the price drifted down about $10 in one quarter. The next reset takes effect October 1, 2026, and every figure on this page tied to J2777 will change with it.
Where you sit down. A physician office, an ambulatory surgery center, and a hospital outpatient department bill the same code at very different rates, and the hospital setting is consistently the most expensive. This is the single biggest variable you can actually control.
No biosimilar competition. FDA’s biosimilar product list carries no faricimab biosimilar as of September 2026. Vabysmo has no cheaper copy, which is unusual in the retina drug aisle and a real reason its price has held.
One eye or two. Every figure here is per eye. If you are treated bilaterally, the drug cost doubles and the injection is billed for each eye.
Whether the practice buys and bills. Most retina practices purchase the drug themselves and bill you for it, which means their acquisition cost, their margin, and their self-pay policy all sit between the national price and your invoice. That is negotiating room.
Cash Price vs. Insurance
Vabysmo is a drug where coverage matters enormously. Under traditional Medicare Part B, the beneficiary coinsurance on J2777 is 20% of the allowed amount, which is about $388.57 on a $1,942.86 dose, and a Medigap or retiree plan often covers that share entirely.
If you have commercial insurance, the Genentech Ophthalmology Co-pay Program can bring your out-of-pocket cost to as little as $0 per treatment, with up to $15,000 in drug assistance per calendar year plus a separate $1,000 per year toward the administration cost. There are no income limits, but the program is closed to anyone on Medicare, Medicare Advantage, Medigap, Medicaid, TRICARE, VA, or DoD coverage, and the administration benefit is unavailable to residents of Massachusetts and Rhode Island.
If you are uninsured, the co-pay program does not apply to you at all, but the Genentech Patient Foundation might. It provides Vabysmo free to uninsured patients with household incomes under $150,000, adding $25,000 for each additional person in households larger than four. Note that the same Genentech page also gives an example of a household of one qualifying at under $75,000, so ask a Foundation Specialist which threshold applies to your household before you assume you are over the line.
The practical upshot: for this drug, the manufacturer’s free-drug program is usually a better route for an uninsured patient than negotiating a cash price, because the drug is the expensive half and Genentech can zero it out.
How to Pay Less
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Apply to the Genentech Patient Foundation first, before you get billed. This is the highest-value move on the page. It requires two forms, a Patient Consent Form from you and a Prescriber Foundation Form from your doctor’s office, and Genentech says it processes requests within five business days once both arrive. The foundation line is (888) 941-3331.
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Choose a physician office over a hospital outpatient department. Medicare’s own rates show the facility fee going from $114.23 to $337.46 for the identical procedure. If a health system is your only option, our guide to hospital price transparency explains how to pull that hospital’s posted cash rate before you schedule, and our charity care checker shows whether the hospital has a financial assistance policy you qualify for.
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Get the quote itemized into three numbers. Drug, injection (CPT 67028), and office visit. Practices quote a single total by default, and the total hides which piece is inflated. Our fair price checker helps you sanity-check the procedure and visit portions, and an eye exam has its own separate cash price worth knowing.
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Ask for the self-pay discount in writing, and ask about the drug separately. Practices that buy and bill expensive injectables almost always have a prompt-pay policy and rarely volunteer it. Our guide to negotiating medical bills has the script, and if a hospital is doing the billing, hospital charity care can wipe out the facility portion entirely.
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Ask your retina specialist what else is on their shelf and what it costs. Other anti-VEGF drugs are priced very differently. Eylea and its aflibercept biosimilars sit at a different price point, and a compounded off-label option costs a small fraction of either. Which drug is right for your eye is a medical decision that belongs to your doctor, but asking what each one would cost you is a fair question and a lot of people never ask it.
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Check the independent charitable foundations if you have Medicare. Genentech’s own page names Good Days, the PAN Foundation, The Assistance Fund, and the HealthWell Foundation as options for publicly insured patients. Their macular degeneration funds open and close during the year, so apply the moment one opens.
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Keep the surrounding care costs from surprising you. A free or sliding-scale clinic can handle routine monitoring visits, and if diabetes is driving your retinal disease, the cost of metformin and a continuous glucose monitor are worth pricing on their own. If a bill has already gone unpaid, our guide to medical bills in collections covers what happens next.
Bottom Line
Budget about $1,943 to $2,484 for the Vabysmo vial and $114 to $337 for the injection itself, which puts a single treatment in one eye at roughly $2,060 to $2,820 as of September 2026. CMS’s real 2024 Medicare data suggests around 4.6 treatments a year and $11,119.52 in annual drug spending per patient, so this is a five-figure annual therapy at retail.
Two things change that math. The Genentech Patient Foundation can take the drug cost to zero for an uninsured household under the income threshold, and choosing a physician office over a hospital outpatient department cuts the procedure cost by about two thirds. Also note that Medicare’s Part B allowance for J2777 resets on October 1, 2026, so re-check the drug figure after that date. If you are pricing eye care more broadly, cataract surgery and glaucoma drops like latanoprost have their own very different cost structures.