HCPCS code J7311: Retisert implant, per 0.01 mg2026 Medicare rate & RVUs in Missouri
Reports fluocinolone acetonide in a Retisert implant placed inside the eye to treat chronic noninfectious uveitis affecting the posterior segment.
CMS doesn’t publish an office rate for J7311 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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.
How the rate is built · J7311
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
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.
Place of service · J7311
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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J7311 isn’t priced in this setting.
J7311 compared with similar codes
Compare codes · National
4 codes, side by side
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.
J7311 billing questions
What distinguishes J7311 from J7313 or J7314?
J7311 identifies the Retisert fluocinolone implant. J7313 and J7314 identify the different fluocinolone implant products Iluvien and Yutiq, respectively.
How many units represent one Retisert implant?
Each J7311 unit represents 0.01 mg. A 0.59 mg implant corresponds to 59 units.
Does J7311 identify the implant procedure?
No. J7311 identifies the Retisert drug item; CPT 67027 describes surgical placement of an intravitreal implant.
How does Medicare treat J7311?
CMS excludes J7311 from the physician fee schedule with status E. When covered, it is treated as a Part B drug generally priced through quarterly ASP files, and coverage is left to the Medicare contractor’s judgment.
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
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