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Medicare Part B payment limits Effective October 1 – December 31, 2026 Posted by CMS September 17, 2026

AfliberceptBevacizumabDenosumabEculizumabEpoetin alfaFilgrastimInfliximabNatalizumabPegfilgrastimRanibizumabRituximabTocilizumabTrastuzumabUstekinumab

Biosimilars · Bevacizumab

Vegzelma is paid 72.0% below Avastin

5 biosimilars bill against Avastin (J9035). On average they are paid ↓ 37.1% relative to the reference product per 10 MG in 4Q26.

  • Avastin (reference)
  • Vegzelma
  • Zirabev
  • Mvasi
  • Alymsys
  • Jobevne
Payment limit per 10 MG, last 8 quarters. Reference product as the thick navy line, biosimilars in teal and other colors.

All products

ProductCodeCMS descriptionPer 10 MGvs. referenceCMS 8% add-on note8 quarters
Avastin J9035 Bevacizumab injection $75.492 Reference –
Vegzelma Q5129 Inj, vegzelma, 10 mg $21.139 ↓ 72.0% Yes
Zirabev Q5118 Inj., zirabev, 10 mg $25.939 ↓ 65.6% Yes
Mvasi Q5107 Inj mvasi 10 mg $28.294 ↓ 62.5% Yes
Alymsys Q5126 Inj alymsys 10 mg $79.982 ↑ 5.9% No
Jobevne Q5160 Inj, jobevne, 10 mg $82.139 ↑ 8.8% No

Payment limits are from the CMS 4Q26 file. Which products are grouped together comes from the site’s biosimilar groups list (reference/biosimilar_groups/2026-10-17T183707Z_d3109bb50c53.csv), checked by hand; it is not a CMS file. “CMS 8% add-on note” shows whether CMS’s notes say the 8% of reference product add-on was applied.

Medicare Part B usage

Bevacizumab market in Medicare

$560.9M Medicare Part B spending, 2025 (preliminary)
506,338 claims in 2025 (preliminary); 14,822,452.4 billing units (10 mg each) in 2024
34.6% of 2025 claims were for biosimilars, vs. 33.9% in 2024
$113.5M spending so far in 2026 (Q1, preliminary)

Spending by product

Market share (share of claims)

Medicare Part B fee-for-service spending and claims by calendar year. Years marked “prelim.” come from CMS’s quarterly spending file and will be replaced when CMS publishes the yearly file. Market share is each product’s percent of the group’s claims that year; claims are used because the quarterly file has no dosage units. A product with no bar for a year is not in CMS’s file for that year.

By product

Product Spending 2024Units 2024Spending per unit 2024Spending 2025 (prelim.) Claims 2025Share of claims 2025 Spending 2026 (Q1)
Avastin J9035 $161,538,584.40 2,264,771.9 $71.32664635 $131,788,780.51 331,234 65.4% $27,113,548.36
Vegzelma Q5129 $98,273,819.47 1,568,807 $62.64238971 $128,788,404.08 41,914 8.3% $30,156,307.08
Zirabev Q5118 $75,813,626.66 3,617,000 $20.96036126 $62,517,209.08 36,252 7.2% $15,941,516.37
Mvasi Q5107 $141,325,402.30 5,471,400 $25.82984287 $137,086,290.47 65,297 12.9% $23,528,409.80
Alymsys Q5126 $108,437,929.80 1,900,473.5 $57.05837506 $100,735,174.69 31,641 6.2% $16,721,621.17
Jobevne Q5160 – – – – – – $87,897.63

Spending, units and claims are CMS figures; spending per unit is CMS’s own average for 2024. Units are billing units, which can differ between codes, so compare units only between codes billed per the same amount. Shares are this site’s calculation from CMS claims. CMS may count spending differently in its quarterly and yearly files, so treat changes between 2024 and 2025 with care.

Physician-billed use by state, 2024

From CMS’s Physician & Other Practitioners by Geography and Service file, which covers drugs billed by physicians and other practitioners, mostly in offices. Drugs billed by hospital outpatient departments are not in it. For these products it covers 38.2% of 2024 Medicare units. CMS leaves out a state’s row for a product when fewer than 11 patients received it, so small states may undercount.

Hover over a state to see its figure. Territories and states with no data are in the table.

Show 55 states and territories
StateServices (billing units)Biosimilar share
California734,252.389.6%
Florida695,02393.9%
Texas650,11993.1%
Illinois321,855.584.0%
Virginia244,34189.8%
Maryland225,42787.3%
Arizona207,02093.0%
Tennessee176,38591.2%
New York174,902.571.0%
New Jersey159,33485.1%
Pennsylvania143,36583.5%
Alabama126,29084.1%
Arkansas107,60895.8%
Georgia104,87477.2%
Ohio103,95393.8%
Minnesota99,16784.3%
Nevada90,98175.7%
Oregon82,07796.4%
Indiana81,33887.3%
South Carolina78,78277.5%
Kansas77,94090.8%
North Carolina77,42476.1%
Michigan76,21888.6%
Iowa74,77395.5%
Missouri68,50580.3%
Washington65,791.690.4%
Nebraska53,80587.9%
Colorado51,31593.4%
Utah50,78190.4%
Oklahoma47,99981.2%
Louisiana47,25180.4%
Mississippi46,53077.0%
New Mexico40,33491.1%
Wisconsin36,08845.8%
Massachusetts27,14933.0%
Connecticut19,77556.3%
North Dakota14,98393.4%
Idaho13,35688.9%
Alaska13,25762.2%
Wyoming12,21789.0%
Delaware8,88181.9%
South Dakota7,68878.7%
Maine7,39769.8%
Vermont7,0560.0%
Puerto Rico5,8580.0%
Kentucky2,358.544.9%
Rhode Island2,1140.0%
Montana1,9020.0%
Guam1,3690.0%
West Virginia1,1950.0%
New Hampshire1,1080.0%
Armed Forces Europe7660.0%
District of Columbia6060.0%
Hawaii290.0%
Northern Mariana Islands290.0%

Sources: 2026-06-25_DSD_PTB_RY26_P06_V10_DYT24_HCPCS-260602.csv, 2026-05-21_MUP_PHY_R26_P05_V10_D24_Geo.csv.gz, 2026-07-23_qddptb_r2603_p06_v10_dqt2601_260722.csv (data.cms.gov).