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

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, 2026One payment locality

CMS doesn’t publish a rate for J7312 in Puerto Rico.

Separate payment rules applyOffice (non-facility)
Separate payment rules applyHospital or facility

Check a contract rate as a % of Medicare · J7312 nationwide

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

We’ll open J7312 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What J7312 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. 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.

How Puerto Rico compares for J7312

J7312 in Puerto Rico vs other payment areas
  1. Puerto Rico · this pageUnavailable
  2. Los Angeles, CA · CaliforniaUnavailable
  3. Washington, DC area · District of ColumbiaUnavailable
  4. Miami, FL · FloridaUnavailable
  5. Chicago, IL · IllinoisUnavailable
  6. Manhattan, NY · New YorkUnavailable
  7. Alaska · AlaskaUnavailable

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

J7312 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama——
ArkansasArkansas——
ArizonaArizona——
Bakersfield, CACalifornia——
Chico, CACalifornia——
El Centro, CACalifornia——
Fresno, CACalifornia——
Hanford, CACalifornia——

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

See J7312 in every payment locality

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.

Codes related to J7312

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

Codes related to J7312
CodeHow it relatesOffice range, Puerto Rico
Often billed with
67028Intravitreal injection, medication delivered into vitreous cavityIdentifies intravitreal administration commonly performed when the J7312 implant is placed.$114.88
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

How J7312 has changed in Puerto Rico

J7312 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Separate payment rules applySeparate payment rules applyRVU26D
2026-07-01Separate payment rules applySeparate payment rules applyRVU26C
2026-04-01Separate payment rules applySeparate payment rules applyRVU26B
2026-01-01Separate payment rules applySeparate payment rules applyRVU26A
2025-10-01Separate payment rules applySeparate payment rules applyRVU25D
2025-07-01Separate payment rules applySeparate payment rules applyRVU25C
2025-04-01Separate payment rules applySeparate payment rules applyRVU25B
2025-01-01Separate payment rules applySeparate payment rules applyRVU25A
2024-10-01Separate payment rules applySeparate payment rules applyRVU24D
2024-07-01Separate payment rules applySeparate payment rules applyRVU24C
2024-04-01Separate payment rules applySeparate payment rules applyRVU24B
2024-03-09Separate payment rules applySeparate payment rules applyRVU24AR
2024-01-01Separate payment rules applySeparate payment rules applyRVU24A
2023-10-01Separate payment rules applySeparate payment rules applyRVU23D
2023-07-01Separate payment rules applySeparate payment rules applyRVU23C
2023-04-01Separate payment rules applySeparate payment rules applyRVU23B
2023-01-01Separate payment rules applySeparate payment rules applyRVU23A
2022-10-01Separate payment rules applySeparate payment rules applyRVU22D
2022-07-01Separate payment rules applySeparate payment rules applyRVU22C
2022-04-01Separate payment rules applySeparate payment rules applyRVU22B
2022-01-01Separate payment rules applySeparate payment rules applyRVU22A
2021-10-01Separate payment rules applySeparate payment rules applyRVU21D
2021-07-01Separate payment rules applySeparate payment rules applyRVU21C
2021-04-01Separate payment rules applySeparate payment rules applyRVU21B
2021-01-01Separate payment rules applySeparate payment rules applyRVU21A
2020-10-01Separate payment rules applySeparate payment rules applyRVU20D
2020-07-01Separate payment rules applySeparate payment rules applyRVU20C
2020-04-01Separate payment rules applySeparate payment rules applyRVU20B
2020-01-01Separate payment rules applySeparate payment rules applyRVU20A
2019-10-01Separate payment rules applySeparate payment rules applyRVU19D
2019-07-01Separate payment rules applySeparate payment rules applyRVU19C
2019-04-01Separate payment rules applySeparate payment rules applyRVU19B
2019-01-01Separate payment rules applySeparate payment rules applyRVU19A
2018-10-01Separate payment rules applySeparate payment rules applyRVU18D
2018-07-01Separate payment rules applySeparate payment rules applyRVU18C
2018-04-01Separate payment rules applySeparate payment rules applyRVU18B
2018-01-01Separate payment rules applySeparate payment rules applyRVU18AR1
2017-10-01Separate payment rules applySeparate payment rules applyRVU17D
2017-07-01Separate payment rules applySeparate payment rules applyRVU17C
2017-04-01Separate payment rules applySeparate payment rules applyRVU17B
2017-01-01Separate payment rules applySeparate payment rules applyRVU17A
2016-10-01Separate payment rules applySeparate payment rules applyRVU16D
2016-07-01Separate payment rules applySeparate payment rules applyRVU16C
2016-04-01Separate payment rules applySeparate payment rules applyRVU16B
2016-01-01Separate payment rules applySeparate payment rules applyRVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Separate payment rules applySeparate payment rules applyRVU14D
2014-07-01Separate payment rules applySeparate payment rules applyRVU14C
2014-04-01Separate payment rules applySeparate payment rules applyRVU14B
2014-01-01Separate payment rules applySeparate payment rules applyRVU14A
2013-10-01Separate payment rules applySeparate payment rules applyRVU13D
2013-07-01Separate payment rules applySeparate payment rules applyRVU13C
2013-04-01Separate payment rules applySeparate payment rules applyRVU13B
2013-01-01Separate payment rules applySeparate payment rules applyRVU13AR

Price J7312 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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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