The highest gear item level in patch 10.1 is a back, Voice of the Silent Star.
This back is dropped by the last boss in the new raid Aberrus, the Shadowed Crucible and it is a rare drop. The ilvl is 457.
The highest ilvl gear in patch 10.1 from non-rare items is 450 ilvl which is from mythic raid, the last two bosses.
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