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HCPCS J7310 Fee Schedule

Last Verified: December 2025

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Ganciclovir, 4.5 mg, long-acting implant
Key FactDetail
Service Type

Drugs Administered Other than Oral Method

Miscellaneous Drugs

Common Place of Service

None

11 - Office

Complexity LevelHigh

National average reimbursement for HCPCS J7310 by major payers:

bcbs

$6,605.82

uhc

$19,418.22

aetna

$8,385.94

cigna

$17,757.49

Preview provider-level rates for...
For billing codeHCPCS J7310
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for HCPCS J7310

United
J7310$19200.001386694701 - TAMPA VAMC593214855FLGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001447218235 - COMMUNITY HOSPITAL630047680 - (AL) COMMUNITY HOSPITAL INCALGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001306938071 - ADVENTIST HEALTH SYSTEM-SUNBELT, INC, ADVENTHEALTH ORLANDO590724459 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INCFLGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001154355188 - BANNER THUNDERBIRD MEDICAL CENTER270036484 - (AZ) BANNER THUNDERBIRD MEDICAL CENTERAZGeneral Acute Care Hospital (282N00000X)
United
J7310$64.001922079094 - SOUTH NASSAU COMMUNITIES HOSPITAL111352310 - (NY) SOUTH NASSAU COMMUNITIES HOSPITALNYGeneral Acute Care Hospital (282N00000X)
United
J7310$27264.001679525919 - THE CLEVELAND CLINIC FOUNDATION455384998 - (OH) CLEVELAND CLINIC SUPPORT SERVICESOHGeneral Acute Care Hospital (282N00000X)
United
J7310$19275.251861883589 - CARILION FRANKLIN MEMORIAL HOSPITAL541586601 - CARILION HEALTHCARE CORPORATIONVAGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001720028772 - BROOKDALE HOSPITAL MEDICAL CENTER111631746 - BROOKDALE HOSPITAL MEDICAL CENTERNYGeneral Acute Care Hospital (282N00000X)
United
J7310$25056.001194744805 - WEST PENN ALLEGHENY HEALTH SYSTEM INC, THE WESTERN PENNSYLVANIA HOSPITAL250969492 - (PA) HIGHMARK HEALTHPAGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001932516283 - CINCINNATI VAMC, FORT THOMAS VAMC310542398 - CINCINNATI VAMCWIGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001114015971 - PROVIDENCE HEALTH & SERVICES OREGON, PROVIDENCE ST VINCENT MEDICAL CENTER930386929 - (OR) PROVIDENCE HEALTH & SERVICES OREGONORGeneral Acute Care Hospital (282N00000X)
United
J7310$20371.191205818481 - ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F, HSHS ST. JOHN'S HOSPITAL370661238 - (IL) ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FILGeneral Acute Care Hospital (282N00000X)
United
J7310$20371.191316938327 - MCLAREN MACOMB381218516 - (MI) MCLAREN MACOMBMIGeneral Acute Care Hospital (282N00000X)
United
J7310$19200.001669782686 - MERCY HOSPITAL160756336 - (NY) MERCY HOSPITAL OF BUFFALONYGeneral Acute Care Hospital (282N00000X)
United
J7310$20352.001578664470 - SUNNYVIEW HOSPITAL AND REHABILITATION CENTER, SUNNYVIEW REHABILITATION HOSPITAL141338386 - (NY) SUNNYVIEW HOSPITAL AND REHABILITATION CENTERNYGeneral Acute Care Hospital (282N00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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HCPCS J7310 vs. Other Miscellaneous Drugs Codes

The HCPCS J7310 code is part of the Drugs Administered Other than Oral Method services used for Miscellaneous Drugs. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The HCPCS J7310 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
J7309-HCPCSLowMethyl aminolevulinate (MAL) for topical administration, 16.8%, 1 gram
J7310-HCPCSHighGanciclovir, 4.5 mg, long-acting implant
J7311-HCPCSModerateInjection, fluocinolone acetonide, intravitreal implant (retisert), 0.01 mg

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS J7310. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the J7310 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

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