HCPCS code J7311: Retisert implant, per 0.01 mg2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for J7311 in California.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What J7311 covers

J7311 identifies Retisert, a fluocinolone acetonide implant placed inside the eye to deliver corticosteroid treatment for chronic noninfectious uveitis affecting the posterior segment. An ophthalmologist typically implants it surgically through the pars plana. The implant contains 0.59 mg of fluocinolone acetonide. The drug item is distinct from the surgical placement service.

CMS assigns J7311 physician fee schedule status E, excluding it from the physician fee schedule. When Medicare covers the item, payment is made under another payment method; the HCPCS pricing method identifies it as a Part B drug generally priced through CMS quarterly ASP drug files. Coverage is left to the Medicare contractor’s judgment. Each billing unit represents 0.01 mg, so one 0.59 mg implant corresponds to 59 units.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where J7311 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the J7311 rate is calculated

Each of J7311’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for J7311

J7311 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

J7311 compared with similar codes

How to choose

J7313Iluvien implantPer 0.01 mg

J7313 identifies the Iluvien fluocinolone implant, not Retisert. Select the code that matches the product furnished.

J7314Yutiq implantPer 0.01 mg

J7314 identifies Yutiq, a different fluocinolone implant product. J7311 is specific to Retisert.

67027Drug implantSurgically implanted system

67027 describes surgical placement of an intravitreal implant. J7311 identifies the Retisert drug item and its billing units.

Codes related to J7311

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates