HCPCS code J7312: Dexamethasone implant, per 0.1 mg2026 Medicare rate & RVUs in Illinois
Reports a sustained-release dexamethasone implant placed inside the eye, commonly for retinal edema or noninfectious inflammation affecting the posterior eye.
CMS doesn’t publish an office rate for J7312 in Illinois.
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 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 in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | Unavailable |
| East St. Louis, IL | Unavailable | Unavailable |
| Rest of Illinois | Unavailable | Unavailable |
| Suburban Chicago, IL | Unavailable | Unavailable |
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
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
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J7312 isn’t priced in this setting.
J7312 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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