HCPCS C9257: Injection, Bevacizumab, 0.25 mg (intravitreal)

Obtain a list of the different documentation and billing requirements needed to properly use and bill for HCPCS code C9257.

Use Code

Frequently asked questions

C9257 (0.25 mg) is the code generally used by facilities (ASC, hospital outpatient) to bill for the drug product for ophthalmologic use. J9035 (10 mg) is the code typically used by office-based physicians (Part B MAC) to bill for the same drug, but the unit of measure is different, reflecting the dose drawn from the vial.

No. While bevacizumab is an FDA-approved cancer treatment, C9257 is specifically intended for the small-dose, ophthalmologic indications (like wet AMD, diabetic macular edema) when billed in a facility setting, as determined by Medicare and other payer policies.

Yes. If the injection is performed in both eyes during the same session, you generally bill the procedure code (e.g., 67028) and the drug code (C9257) on two separate lines—one for the right eye with modifier -RT and one for the left eye with modifier -LT. You would report one unit of C9257 per line, for a total of two units. Alternatively, some payers accept one line with the -50 bilateral modifier for the procedure code, but you should verify your payer's specific rule.