In short

J7311 is the HCPCS Level II code for injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg. CMS assigns NDCs for Retisert to it. One billing unit is 0.01 mg. The Medicare Part B payment limit is $341.131 per unit (October 1, 2026 through December 31, 2026).

Code

CMS HCPCS file
HCPCS codeJ7311
Billing unit0.01 mg
Descriptor
Injection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg
Short descriptor
Inj., retisert, 0.01 mg
Code set
HCPCS Level II, maintained by CMS
Effective
Oct 1, 2019

The billing unit is read from the descriptor. Confirm it against the CMS file before billing.

Medicare Part B payment limit

CMS ASP file
Payment limit per unit$341.131
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

Units and claim line

Units = dose given ÷ 0.01 mg. For example, 1 mg is 100 units. Enter the dose to get the units and the NDC line for the CMS-1500 and the 837P.

Enter the dose given to build the claim line.

NDCs billed under J7311

CMS’s ASP NDC–HCPCS crosswalk (effective October 1, 2026 through December 31, 2026) assigns 1 NDC to J7311 for Retisert. Billing units per package are CMS’s figures for this code’s unit.

NDCs assigned to J7311 in the CMS ASP crosswalk
DrugNDC (11-digit)LabelerPackageBilling units per package
Retisert24208-0416-01Bausch & Lomb Americas Inc.159

J7311: common questions

Is J7311 a CPT code?
No. J7311 is a HCPCS Level II code, maintained by CMS, that identifies the drug supplied. CPT codes are five-digit numbers from the AMA that describe services. Giving the drug, for example an injection or infusion, is usually reported with a separate CPT administration code. CPT codes for drug administration.
What NDCs are billed under J7311?
CMS's ASP crosswalk for October 1, 2026 through December 31, 2026 lists 1 NDC under J7311, for Retisert. The table on this page shows each one with its billing units per package.
What is the Medicare payment limit for J7311?
$341.131 per 0.01 mg, effective October 1, 2026 through December 31, 2026, from CMS's Part B drug payment limit file. Multiply by the units billed for the allowed amount before deductible and coinsurance. It is not a coverage decision.
What is one billing unit of J7311?
One unit of J7311 is 0.01 mg, as stated in the code's descriptor. Units to report = dose given ÷ 0.01 mg. J-code billing units.

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