In short

Iluvien is billed under HCPCS J7313 — Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg. One billing unit is 0.01 mg. CMS's crosswalk lists 1 Iluvien NDC under this code.

J7313 code details

Reference

J7313
Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mgBilling unit: 0.01 mg
Labelers
ANI Pharmaceuticals, Inc.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$516.516
Per0.01 mg
Coinsurance20%

Effective October 1, 2026 through December 31, 2026. Payment allowance limits subject to the ASP methodology are based on 2Q26 ASP data. A payment limit is not a coverage decision; the Medicare contractor decides coverage. CMS ASP pricing files

Iluvien units and claim line

Enter the dose given to get the J7313 units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

Iluvien NDCs and billing units

From CMS’s ASP NDC–HCPCS crosswalk, effective October 1, 2026 through December 31, 2026. Billing units per package are CMS’s figures for the code’s unit.

Iluvien NDCs in the CMS ASP crosswalk
NDC (11-digit)HCPCSLabelerPackageBilling units per package
68611-0190-02J7313ANI Pharmaceuticals, Inc.119

Iluvien: common questions

What is the J-code for Iluvien?
Iluvien is billed under HCPCS J7313 — Injection, fluocinolone acetonide, intravitreal implant (iluvien), 0.01 mg. One billing unit is 0.01 mg. CMS's crosswalk lists 1 Iluvien NDC under this code.
How many J7313 billing units are in a package of Iluvien?
CMS lists 19 billing units per package, depending on the NDC, where one unit is 0.01 mg. Units to report are based on the dose given, not the package.
Is J7313 a CPT code?
No. J7313 is a HCPCS Level II code from CMS for the drug itself. Giving it, for example by injection or infusion, is usually reported with a separate CPT administration code.

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