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HCPCS code J7312: Dexamethasone implant, per 0.1 mg2026 Medicare rate & RVUs

Reports a sustained-release dexamethasone implant placed inside the eye, commonly for retinal edema or noninfectious inflammation affecting the posterior eye.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · J7312

Dexamethasone implant, per 0.1 mg

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for J7312 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What J7312 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What J7312 covers

J7312 identifies a dexamethasone implant placed in the vitreous cavity of the eye. Ophthalmologists, often retinal specialists, administer the implant by intravitreal injection. It is used for conditions including macular edema associated with retinal vein occlusion or diabetic macular edema, and noninfectious inflammation affecting the posterior segment of the eye. The marketed product is Ozurdex.

CMS assigns this code physician fee schedule status E, excluding it from the physician fee schedule. When Medicare covers the item, payment is made under another method; HCPCS classifies it as a Part B drug, generally paid using CMS quarterly ASP drug pricing files when covered. The Medicare contractor determines coverage. Each unit represents 0.1 mg of dexamethasone, so a 0.7 mg implant is reported as 7 units. CPT 67028 identifies the intravitreal administration service, separate from the drug code.

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 J7312 pays more and less

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

109 of 109 payment localities

J7312 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

J7312 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
J7312 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the J7312 rate is calculated

Each of J7312’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 · J7312

RVUs × geographic indexes × conversion factor

Office or facility?

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 J7312

J7312 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 · J7312

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

J7312 isn’t priced in this setting.

J7312 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • J7312

    Dexamethasone implant, per 0.1 mg0 wRVU

    Not priced

  • J7311

    Retisert implant, per 0.01 mg0 wRVU

    Not priced

  • J7313

    Iluvien implant, per 0.01 mg0 wRVU

    Not priced

  • J7314

    Yutiq implant, per 0.01 mg0 wRVU

    Not priced

How to choose

J7311Retisert implantPer 0.01 mg
J7311 identifies a fluocinolone acetonide implant, not dexamethasone. Its units represent 0.01 mg, rather than J7312's 0.1 mg.
J7313Iluvien implantPer 0.01 mg
J7313 is for a fluocinolone acetonide implant used for diabetic macular edema. J7312 identifies dexamethasone and uses a different drug-unit increment.
J7314Yutiq implantPer 0.01 mg
J7314 identifies a fluocinolone acetonide implant used for chronic noninfectious posterior-segment uveitis; J7312 identifies dexamethasone.

Codes related to J7312

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

Codes related to J7312
CodeHow it relatesNational office range
Often billed with
67028Intravitreal injection, medication delivered into vitreous cavityIdentifies intravitreal administration commonly performed when the J7312 implant is placed.$103.45–$145.87
Used instead
J7311Retisert implant, per 0.01 mgIdentifies a fluocinolone acetonide implant used for certain cases of posterior-segment uveitis.No office rate
J7313Iluvien implant, per 0.01 mgIdentifies a fluocinolone acetonide implant used for diabetic macular edema.No office rate
J7314Yutiq implant, per 0.01 mgIdentifies a fluocinolone acetonide implant used for chronic noninfectious posterior-segment uveitis.No office rate

J7312 billing questions

How many J7312 units represent one 0.7 mg implant?

Each unit represents 0.1 mg of dexamethasone. A 0.7 mg implant therefore represents 7 units.

Is the implant administration reported with J7312?

J7312 identifies the dexamethasone implant. CPT 67028 identifies its intravitreal administration and is commonly reported for the same encounter.

How does J7312 differ from J7313 or J7314?

J7312 is for dexamethasone in 0.1 mg units. J7313 and J7314 identify fluocinolone acetonide implants in 0.01 mg units, so select the code matching the implanted drug.

How does Medicare treat J7312?

CMS assigns status E, excluding the code from the physician fee schedule. When covered, Medicare generally pays for the Part B drug through the quarterly ASP pricing files, with coverage determined by the Medicare contractor.

What documentation supports the number of units?

Document the dexamethasone product and dose administered. Report units based on 0.1 mg per unit.

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

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